Pub Date : 2025-10-01Epub Date: 2025-03-17DOI: 10.1016/j.redar.2025.501801
C. Beltrán Piles, B. Monleón, R. Badenes, D. Tabares, P. Capilla
Anterior cervical discectomy and fusion (ACDF) is a common surgical procedure with positive outcomes, but it is not without potentially serious complications for the patient.
We present the case of a patient who underwent ACDF and was found to have a cervical swelling prior to extubation. After a joint evaluation with the otolaryngology team, a suspicion of laryngeal structure dislocation was raised. A manual repositioning was performed prior to neuromuscular relaxation, and the patient was transferred intubated to the Recovery Unit due to a high risk of upper airway obstruction secondary to edema.
After 24 hours of monitoring under scheduled corticosteroid treatment, a planned and safe extubation was carried out, witnessed by the otolaryngology team.
{"title":"Manejo anestésico de la dislocación laríngea tras discectomía y fusión cervical anterior","authors":"C. Beltrán Piles, B. Monleón, R. Badenes, D. Tabares, P. Capilla","doi":"10.1016/j.redar.2025.501801","DOIUrl":"10.1016/j.redar.2025.501801","url":null,"abstract":"<div><div>Anterior cervical discectomy and fusion (ACDF) is a common surgical procedure with positive outcomes, but it is not without potentially serious complications for the patient.</div><div>We present the case of a patient who underwent ACDF and was found to have a cervical swelling prior to extubation. After a joint evaluation with the otolaryngology team, a suspicion of laryngeal structure dislocation was raised. A manual repositioning was performed prior to neuromuscular relaxation, and the patient was transferred intubated to the Recovery Unit due to a high risk of upper airway obstruction secondary to edema.</div><div>After 24<!--> <!-->hours of monitoring under scheduled corticosteroid treatment, a planned and safe extubation was carried out, witnessed by the otolaryngology team.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 8","pages":"Article 501801"},"PeriodicalIF":0.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145134786","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}
Pub Date : 2025-08-01Epub Date: 2025-07-23DOI: 10.1016/j.redar.2025.501920
E.M. Aldana , C. Aldecoa
{"title":"Delirium postoperatorio: de la evidencia internacional a la práctica en España. Una asignatura pendiente","authors":"E.M. Aldana , C. Aldecoa","doi":"10.1016/j.redar.2025.501920","DOIUrl":"10.1016/j.redar.2025.501920","url":null,"abstract":"","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 7","pages":"Article 501920"},"PeriodicalIF":0.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144722116","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}
Postoperative delirium (POD) is an adverse outcome that has garnered significant interest in perioperative medicine, particularly in older adults, due to its association with increased morbidity, mortality, and health care costs. In Colombia, this disease is under-reported due to the lack of POD diagnosis and prevention protocols. The aim of this study was to determine the incidence and potential risk factors of POD, and its association with other postoperative complications.
Materials and methods
This retrospective cohort study was performed at a tertiary care hospital. Patients over 60 years of age who underwent surgery between 2012 and 2019 were included. Random sampling was used to analyse electronic medical records to estimate the incidence of POD, risk factors, and postoperative complications within 7 days of surgery.
Results
A total of 2535 patients were evaluated. The cumulative incidence of POD was 6.0% (95% confidence interval [CI]: 5.1%-6.9%), with most cases (67%) occurring within the first 3 postoperative days. Risk factors associated with POD included a history of psychiatric disorders, preoperative opioid use, ASA (American Society of Anesthesiologists) class III/IV, vascular surgery, urgent or emergency surgery, and functional dependency. POD was also associated with higher in-hospital mortality (OR: 2.9; 95% CI: 1.66-5.07).
Conclusion
POD is common in patients aged over 60 undergoing surgery, particularly those that undergo urgent or emergency procedures and vascular surgery, who are ASA class > III, functionally dependent, and present psychiatric disorders. POD is also associated with increased postoperative morbidity and mortality.
{"title":"Delirio postoperatorio en adultos mayores: un estudio de cohorte retrospectivo","authors":"J.A. Vélez-Restrepo , P.A. Betancourt-Ángel , J.D. Caicedo-Jaramillo , F.D. Casas-Arroyave","doi":"10.1016/j.redar.2025.501855","DOIUrl":"10.1016/j.redar.2025.501855","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Postoperative delirium (POD) is an adverse outcome that has garnered significant interest in perioperative medicine, particularly in older adults, due to its association with increased morbidity, mortality, and health care costs. In Colombia, this disease is under-reported due to the lack of POD diagnosis and prevention protocols. The aim of this study was to determine the incidence and potential risk factors of POD, and its association with other postoperative complications.</div></div><div><h3>Materials and methods</h3><div>This retrospective cohort study was performed at a tertiary care hospital. Patients over 60<!--> <!-->years of age who underwent surgery between 2012 and 2019 were included. Random sampling was used to analyse electronic medical records to estimate the incidence of POD, risk factors, and postoperative complications within 7<!--> <!-->days of surgery.</div></div><div><h3>Results</h3><div>A total of 2535 patients were evaluated. The cumulative incidence of POD was 6.0% (95% confidence interval [CI]: 5.1%-6.9%), with most cases (67%) occurring within the first 3<!--> <!-->postoperative days. Risk factors associated with POD included a history of psychiatric disorders, preoperative opioid use, ASA (American Society of Anesthesiologists) class<!--> <!-->III/IV, vascular surgery, urgent or emergency surgery, and functional dependency. POD was also associated with higher in-hospital mortality (OR: 2.9; 95%<!--> <!-->CI: 1.66-5.07).</div></div><div><h3>Conclusion</h3><div>POD is common in patients aged over 60 undergoing surgery, particularly those that undergo urgent or emergency procedures and vascular surgery, who are ASA class ><!--> <!-->III, functionally dependent, and present psychiatric disorders. POD is also associated with increased postoperative morbidity and mortality.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 7","pages":"Article 501855"},"PeriodicalIF":0.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144722122","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}
Pub Date : 2025-08-01Epub Date: 2025-04-16DOI: 10.1016/j.redar.2025.501805
O. de la Varga-Martínez , R. Badenes , C. Gordaliza , S. de Miguel Manso , G.E. Landázuri Castillo , C. Armenteros Aragon , M. Fernández Castro , A.B. Martin Santos , R. Lopez Herrero , R. Navarro Pérez , A. Abad Gurumeta , M. Varela Duran , M. Heredia Rodriguez , E. Tamayo Gómez , revisores externos
The aim of this clinical practice guideline is to provide a rationale for the implementation of the Zero Delirium Project (ZDP) - a series of recommendations for patients in special critical care units (SCCU). The recommendations were developed by a group of anaesthesiologists from around Spain, and were reviewed by the Scientific Committee of the Spanish Society of Anaesthesiology, Resuscitation and Pain Therapy.
Delirium is an acute, fluctuating, multifactorial syndrome characterised by inattention, disorganised thinking, and an altered level of consciousness. It may affect up to 56% in patients during their stay in critical care, and is important because many SCCUs have not yet introduced routine delirium screening, treatment and prevention strategies. Staff that are able to recognise and diagnose delirium can prevent it, treat it and reduce its incidence, which in turn reduces morbidity, mortality and costs. The ZDP was created with this aim in mind.
{"title":"Guía clínica y plan estratégico para la prevención, el diagnóstico y el tratamiento del delirium: Proyecto Delirium Zero","authors":"O. de la Varga-Martínez , R. Badenes , C. Gordaliza , S. de Miguel Manso , G.E. Landázuri Castillo , C. Armenteros Aragon , M. Fernández Castro , A.B. Martin Santos , R. Lopez Herrero , R. Navarro Pérez , A. Abad Gurumeta , M. Varela Duran , M. Heredia Rodriguez , E. Tamayo Gómez , revisores externos","doi":"10.1016/j.redar.2025.501805","DOIUrl":"10.1016/j.redar.2025.501805","url":null,"abstract":"<div><div>The aim of this clinical practice guideline is to provide a rationale for the implementation of the Zero Delirium Project (ZDP) - a series of recommendations for patients in special critical care units (SCCU). The recommendations were developed by a group of anaesthesiologists from around Spain, and were reviewed by the Scientific Committee of the Spanish Society of Anaesthesiology, Resuscitation and Pain Therapy.</div><div>Delirium is an acute, fluctuating, multifactorial syndrome characterised by inattention, disorganised thinking, and an altered level of consciousness. It may affect up to 56% in patients during their stay in critical care, and is important because many SCCUs have not yet introduced routine delirium screening, treatment and prevention strategies. Staff that are able to recognise and diagnose delirium can prevent it, treat it and reduce its incidence, which in turn reduces morbidity, mortality and costs. The ZDP was created with this aim in mind.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 7","pages":"Article 501805"},"PeriodicalIF":0.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144721974","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}
Pub Date : 2025-08-01Epub Date: 2024-12-06DOI: 10.1016/j.redar.2024.501666
B. Rodríguez Sánchez , I. Fuertes Arenal , J.J. Algaba Jaramillo , P. Morillas Sendin
{"title":"Utilidad de la ecografía en el diagnóstico diferencial del edema cervical posoperatorio tras la cirugía de columna cervical posterior","authors":"B. Rodríguez Sánchez , I. Fuertes Arenal , J.J. Algaba Jaramillo , P. Morillas Sendin","doi":"10.1016/j.redar.2024.501666","DOIUrl":"10.1016/j.redar.2024.501666","url":null,"abstract":"","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 7","pages":"Article 501666"},"PeriodicalIF":0.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144722117","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}
Pub Date : 2025-08-01Epub Date: 2025-02-28DOI: 10.1016/j.redar.2025.501768
R. García Álvarez , F. Ramasco , J. Nieves Alonso , L. Mouriz , P. Rama , I. Bilbao , A. Pérez Carbonell , M.A. Rodenas , F. Ortega , M. Vives , C.A. Calvo , M. Taboada , A. Azzam , M. Merino , F. Martínez , D. Domínguez , C.T. de Llano , R. Adalia , G. Aguilar , C. Aldecoa , G. Hernández
Introduction
In cases of arterial hypotension and/or hypoperfusion that do not respond to fluid therapy, the administration of intravenous catecholamines, especially norepinephrine, is usually the treatment of choice. However, prolonged exposure to high doses of norepinephrine increases mortality, as well as the possibility of arrhythmias, organ damage, and tissue ischemia. An early multimodal vasopressor strategy, which involves adding vasopressin (a drug with a mechanism of action different from catecholamines) to low-dose norepinephrine, could improve the safety profile.
Objectives
The main objective is to characterise the routine clinical practice of vasopressin (VASOPRES) use in the context of shock, collecting clinical, analytical and echocardiographic data.
Materials and methods
The VASOPRES Registry is a prospective multicentre observational study, in which critical care anaesthesia units from all over Spain will participate, collecting data on patients over 18 years of age in whom treatment with vasopressin is initiated, regardless of the type of shock they present. The duration of the study is estimated at 24 months, starting from its approval by the Clinical Research Ethics Committee (CEIm).
Results
Data collection started in July 2024 and is expected to end in July 2026.
Ethics and publications
The VASOPRES Registry has already been approved by the Clinical Research Ethics Committee of the Hospital Universitario de La Princesa, Madrid (registration number 5596) in May 2024. The study is registered in ClinicalTrials.gov under the number NCT06422975 and in the Spanish Clinical Trials Register (REec) through the GESTO platform (Observational studys with authorized medicines) under the identification number 0083-2024-OBS. The results will be published in specialised journals and presented at conferences and congresses.
Conclusions
The Vasopres Registry may provide insight into the uncertainties that still exist about the use of AVP as well as its use in routine clinical practice in various types of shock. Furthermore, it is also hoped that the results of this study will identify potential areas for improvement where more targeted research is needed.
{"title":"Estudio prospectivo observacional multicéntrico de los pacientes en shock en tratamiento con vasopresina: protocolo de estudio del Registro VASOPRES","authors":"R. García Álvarez , F. Ramasco , J. Nieves Alonso , L. Mouriz , P. Rama , I. Bilbao , A. Pérez Carbonell , M.A. Rodenas , F. Ortega , M. Vives , C.A. Calvo , M. Taboada , A. Azzam , M. Merino , F. Martínez , D. Domínguez , C.T. de Llano , R. Adalia , G. Aguilar , C. Aldecoa , G. Hernández","doi":"10.1016/j.redar.2025.501768","DOIUrl":"10.1016/j.redar.2025.501768","url":null,"abstract":"<div><h3>Introduction</h3><div>In cases of arterial hypotension and/or hypoperfusion that do not respond to fluid therapy, the administration of intravenous catecholamines, especially norepinephrine, is usually the treatment of choice. However, prolonged exposure to high doses of norepinephrine increases mortality, as well as the possibility of arrhythmias, organ damage, and tissue ischemia. An early multimodal vasopressor strategy, which involves adding vasopressin (a drug with a mechanism of action different from catecholamines) to low-dose norepinephrine, could improve the safety profile.</div></div><div><h3>Objectives</h3><div>The main objective is to characterise the routine clinical practice of vasopressin (VASOPRES) use in the context of shock, collecting clinical, analytical and echocardiographic data.</div></div><div><h3>Materials and methods</h3><div>The VASOPRES Registry is a prospective multicentre observational study, in which critical care anaesthesia units from all over Spain will participate, collecting data on patients over 18 years of age in whom treatment with vasopressin is initiated, regardless of the type of shock they present. The duration of the study is estimated at 24 months, starting from its approval by the Clinical Research Ethics Committee (CEIm).</div></div><div><h3>Results</h3><div>Data collection started in July 2024 and is expected to end in July 2026.</div></div><div><h3>Ethics and publications</h3><div>The VASOPRES Registry has already been approved by the Clinical Research Ethics Committee of the Hospital Universitario de La Princesa, Madrid (registration number 5596) in May 2024. The study is registered in ClinicalTrials.gov under the number NCT06422975 and in the Spanish Clinical Trials Register (REec) through the GESTO platform (Observational studys with authorized medicines) under the identification number 0083-2024-OBS. The results will be published in specialised journals and presented at conferences and congresses.</div></div><div><h3>Conclusions</h3><div>The Vasopres Registry may provide insight into the uncertainties that still exist about the use of AVP as well as its use in routine clinical practice in various types of shock. Furthermore, it is also hoped that the results of this study will identify potential areas for improvement where more targeted research is needed.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 7","pages":"Article 501768"},"PeriodicalIF":0.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144721964","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}
Pub Date : 2025-08-01Epub Date: 2025-05-23DOI: 10.1016/j.redar.2025.501853
A. Lara-Jiménez , P. Monedero , G. Echarri
Background
The urinary biomarker [TIMP-2] × [IGFBP7] enables the prediction of postoperative acute kidney injury (PO-AKI). Our study aimed to assess the incidence of PO-AKI in high-risk patients undergoing major abdominal surgery and to evaluate the impact of implementing KDIGO renal optimization measures in those with renal stress identified by [TIMP-2] × [IGFBP7].
Materials and methods
This was a prospective study including 182 patients who underwent major abdominal surgery. Perioperative data, [TIMP-2] × [IGFBP7] levels, and the implementation of KDIGO renal protection strategies in the ICU were collected. Predictors of PO-AKI were identified through multivariate analysis.
Results
The overall incidence of PO-AKI was 25.3%, reaching 42.7% in ICU patients. [TIMP-2] × [IGFBP7] showed moderate predictive ability (AUROC = .74), with a PO-AKI incidence of 47.5% in patients with elevated levels. Despite the implementation of KDIGO measures in the ICU, the incidence of PO-AKI in patients with elevated [TIMP-2] × [IGFBP7] was 65.6%. In multivariate analysis, the main predictors of PO-AKI were elevated [TIMP-2] × [IGFBP7] (OR = 6.3; 95% CI: 2.6-15.6; P < .001), male sex (OR = 6.1; 95% CI: 1.9-19.6; P = .002), and ICU admission (OR = 4.5; 95% CI: 1.5-13.6; P = .009).
Conclusions
PO-AKI is common after major abdominal surgery, particularly in ICU patients. The [TIMP-2] × [IGFBP7] biomarker allows for early identification of at-risk patients, although the implementation of KDIGO measures in the ICU did not significantly reduce its incidence.
{"title":"Lesión renal aguda postoperatoria en cirugía mayor abdominal. Utilidad del biomarcador urinario [TIMP-2] × [IGFBP7] (NephroCheck®)","authors":"A. Lara-Jiménez , P. Monedero , G. Echarri","doi":"10.1016/j.redar.2025.501853","DOIUrl":"10.1016/j.redar.2025.501853","url":null,"abstract":"<div><h3>Background</h3><div>The urinary biomarker [TIMP-2]<!--> <!-->×<!--> <!-->[IGFBP7] enables the prediction of postoperative acute kidney injury (PO-AKI). Our study aimed to assess the incidence of PO-AKI in high-risk patients undergoing major abdominal surgery and to evaluate the impact of implementing KDIGO renal optimization measures in those with renal stress identified by [TIMP-2]<!--> <!-->×<!--> <!-->[IGFBP7].</div></div><div><h3>Materials and methods</h3><div>This was a prospective study including 182 patients who underwent major abdominal surgery. Perioperative data, [TIMP-2]<!--> <!-->×<!--> <!-->[IGFBP7] levels, and the implementation of KDIGO renal protection strategies in the ICU were collected. Predictors of PO-AKI were identified through multivariate analysis.</div></div><div><h3>Results</h3><div>The overall incidence of PO-AKI was 25.3%, reaching 42.7% in ICU patients. [TIMP-2]<!--> <!-->×<!--> <!-->[IGFBP7] showed moderate predictive ability (AUROC<!--> <!-->=<!--> <!-->.74), with a PO-AKI incidence of 47.5% in patients with elevated levels. Despite the implementation of KDIGO measures in the ICU, the incidence of PO-AKI in patients with elevated [TIMP-2]<!--> <!-->×<!--> <!-->[IGFBP7] was 65.6%. In multivariate analysis, the main predictors of PO-AKI were elevated [TIMP-2]<!--> <!-->×<!--> <!-->[IGFBP7] (OR<!--> <!-->=<!--> <!-->6.3; 95%<!--> <!-->CI: 2.6-15.6; <em>P</em> <!--><<!--> <!-->.001), male sex (OR<!--> <!-->=<!--> <!-->6.1; 95%<!--> <!-->CI: 1.9-19.6; <em>P</em> <!-->=<!--> <!-->.002), and ICU admission (OR<!--> <!-->=<!--> <!-->4.5; 95%<!--> <!-->CI: 1.5-13.6; <em>P</em> <!-->=<!--> <!-->.009).</div></div><div><h3>Conclusions</h3><div>PO-AKI is common after major abdominal surgery, particularly in ICU patients. The [TIMP-2]<!--> <!-->×<!--> <!-->[IGFBP7] biomarker allows for early identification of at-risk patients, although the implementation of KDIGO measures in the ICU did not significantly reduce its incidence.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 7","pages":"Article 501853"},"PeriodicalIF":0.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144722121","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}
Pub Date : 2025-08-01Epub Date: 2025-06-17DOI: 10.1016/j.redar.2025.501850
M. Bardají-Carrillo , M. Martín-Fernández , A. García-Concejo , Á. Tamayo-Velasco , D. Bernardo , E. Tamayo
Introduction
Given the key role of the endothelium in organ failure secondary to sepsis, we reviewed the available literature on the use of flow cytometry (FC) to analyse endothelial cells in human sepsis.
Methods
We systematically searched PubMed and Web of Science from inception until November 2024 to identify original research articles describing the use of FC to study human endothelial cells in sepsis.
Results
A total of 395 original articles were found; 36 met the inclusion criteria. Ten studied circulating mature (CEC) or progenitor (CEPC) endothelial cells. High CEC and/or CEPC counts correlated with higher mortality; CEC numbers were increased even before the onset of shock. Twenty-six manuscripts studied the phenotype of different human microvascular endothelial cells (HMEC), and showed that expression of adhesion molecules ICAM-1, VCAM-1 and E-selectin were increased in sepsis, but there was no evidence of their association with severity or mortality.
Conclusion
High CEC and CEPC counts correlate with sepsis severity and mortality, confirming that their assessment by FC can shed some light on early sepsis diagnosis.
鉴于内皮在脓毒症继发器官衰竭中的关键作用，我们回顾了利用流式细胞术（FC）分析人类脓毒症中内皮细胞的现有文献。方法系统检索PubMed和Web of Science从成立到2024年11月，以确定描述使用FC研究脓毒症中的人内皮细胞的原始研究文章。结果共发现原创文章395篇；36例符合纳入标准。10个研究循环成熟（CEC）或祖（CEPC）内皮细胞。高CEC和/或CEPC计数与高死亡率相关；甚至在休克开始前CEC数就增加了。26篇文献研究了不同人微血管内皮细胞（HMEC）的表型，结果显示黏附分子ICAM-1、VCAM-1和e -选择素在脓毒症中表达增加，但没有证据表明它们与严重程度或死亡率相关。结论高CEC和高CEPC计数与脓毒症严重程度和死亡率相关，证实了FC对其的评估有助于脓毒症的早期诊断。
{"title":"Explorar el rol de la citometría de flujo para la evaluación de las células endoteliales en la sepsis humana: una revisión sistemática","authors":"M. Bardají-Carrillo , M. Martín-Fernández , A. García-Concejo , Á. Tamayo-Velasco , D. Bernardo , E. Tamayo","doi":"10.1016/j.redar.2025.501850","DOIUrl":"10.1016/j.redar.2025.501850","url":null,"abstract":"<div><h3>Introduction</h3><div>Given the key role of the endothelium in organ failure secondary to sepsis, we reviewed the available literature on the use of flow cytometry (FC) to analyse endothelial cells in human sepsis.</div></div><div><h3>Methods</h3><div>We systematically searched PubMed and Web of Science from inception until November 2024 to identify original research articles describing the use of FC to study human endothelial cells in sepsis.</div></div><div><h3>Results</h3><div>A total of 395 original articles were found; 36 met the inclusion criteria. Ten studied circulating mature (CEC) or progenitor (CEPC) endothelial cells. High CEC and/or CEPC counts correlated with higher mortality; CEC numbers were increased even before the onset of shock. Twenty-six manuscripts studied the phenotype of different human microvascular endothelial cells (HMEC), and showed that expression of adhesion molecules ICAM-1, VCAM-1 and E-selectin were increased in sepsis, but there was no evidence of their association with severity or mortality.</div></div><div><h3>Conclusion</h3><div>High CEC and CEPC counts correlate with sepsis severity and mortality, confirming that their assessment by FC can shed some light on early sepsis diagnosis.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 7","pages":"Article 501850"},"PeriodicalIF":0.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144722123","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}
Pub Date : 2025-08-01Epub Date: 2025-02-25DOI: 10.1016/j.redar.2025.501772
P. Cruz, A. Puig, E. de la Fuente, S. González, M. Rueda, M. Portas
Tracheal resection surgery for critical stenosis requires a highly specialized and multidisciplinary team, with the primary objectives being adequate airway management, safe ventilation, and optimal exposure of the surgical field. This necessitates effective communication and coordination between the anaesthetic and surgical teams.
We present two clinical cases of critical tracheal stenosis surgery in which intubation was performed with the patient awake. A small-gauge tube with pneumotaponation (Tritube®, Ventinova Medical B.V.; Eindhoven, The Netherlands) was placed, along with a flow-controlled ventilation system (Evone®, Ventinova Medical B.V.; Eindhoven, The Netherlands), as a strategy to be considered for this type of surgery.
气管切除术治疗严重狭窄需要高度专业化和多学科的团队，主要目标是充分的气道管理，安全通气和最佳的手术野暴露。这需要麻醉和手术团队之间的有效沟通和协调。我们提出两例危重气管狭窄手术的临床病例，其中插管是在病人清醒的情况下进行的。一种带气垫的小规格管(Tritube®，Ventinova Medical B.V.；Eindhoven, Netherlands)和流量控制通风系统(Evone®，Ventinova Medical B.V.；埃因霍温，荷兰)，作为这类手术的策略。
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Pub Date : 2025-08-01Epub Date: 2025-06-26DOI: 10.1016/j.redar.2025.501880
L. Monteagudo Moreno , P. Cía Blasco , M. Malo Urriés , A. Nuez Polo , C. Marín Zaldívar
Background and objectives
Neuropathic pain (NP) is a widespread, complex disorder that responds differently to pharmacological treatment. The aim of this study was to identify the baseline characteristics of good response to capsaicin 8% patch in patients with trauma-induced peripheral neuropathic pain (PNP).
Materials and methods
We performed a prospective, longitudinal, open-label study in 31 patients with PNP treated with 1-3 applications of the capsaicin 8% patch for 52 weeks. Response to treatment was defined as a reduction in the Visual Analogue Scale (VAS) score compared to baseline. Data from responders and non-responders were compared at the start (month 1) and end (month 12) of treatment. Logistic regression was used to identify predictors of treatment response.
Results
At month 1, responders (n = 17) had significantly larger treatment areas (155.18 cm2 vs. 59.21 cm2; P=.004) and reported greater pain relief with treatments received in the previous week in the brief pain questionnaire (34.7% vs. 14.3%; P=.023). At month 12, significant predictors included cold allodynia (OR 8; P=.030), positive for painful cold in the DN4 questionnaire (OR 7.936; P=.019), no penetrating pain (OR 16.800; P=.009), and pain interference with work score < 7.5 (OR 7.917; P=.019).
Conclusions
This study makes a significant contribution to the management of post-traumatic peripheral neuropathic pain by providing tools to personalize treatment and optimize available resources.
{"title":"Reglas de predicción clínica en los pacientes con dolor neuropático periférico de etiología traumática tratados con parche de capsaicina al 8%","authors":"L. Monteagudo Moreno , P. Cía Blasco , M. Malo Urriés , A. Nuez Polo , C. Marín Zaldívar","doi":"10.1016/j.redar.2025.501880","DOIUrl":"10.1016/j.redar.2025.501880","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Neuropathic pain (NP) is a widespread, complex disorder that responds differently to pharmacological treatment. The aim of this study was to identify the baseline characteristics of good response to capsaicin 8% patch in patients with trauma-induced peripheral neuropathic pain (PNP).</div></div><div><h3>Materials and methods</h3><div>We performed a prospective, longitudinal, open-label study in 31 patients with PNP treated with 1-3 applications of the capsaicin 8% patch for 52 weeks. Response to treatment was defined as a reduction in the Visual Analogue Scale (VAS) score compared to baseline. Data from responders and non-responders were compared at the start (month 1) and end (month 12) of treatment. Logistic regression was used to identify predictors of treatment response.</div></div><div><h3>Results</h3><div>At month 1, responders (n<!--> <!-->=<!--> <!-->17) had significantly larger treatment areas (155.18 cm<sup>2</sup> vs. 59.21 cm<sup>2</sup>; <em>P</em>=.004) and reported greater pain relief with treatments received in the previous week in the brief pain questionnaire (34.7% vs. 14.3%; <em>P</em>=.023). At month 12, significant predictors included cold allodynia (OR 8; <em>P</em>=.030), positive for painful cold in the DN4 questionnaire (OR 7.936; <em>P</em>=.019), no penetrating pain (OR 16.800; <em>P</em>=.009), and pain interference with work score <<!--> <!-->7.5 (OR 7.917; <em>P</em>=.019).</div></div><div><h3>Conclusions</h3><div>This study makes a significant contribution to the management of post-traumatic peripheral neuropathic pain by providing tools to personalize treatment and optimize available resources.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 7","pages":"Article 501880"},"PeriodicalIF":0.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144721975","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}
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