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Relapsing polichondritis affecting the tracheobronquial tree in a patient with preeclampsia with severe features. 一名先兆子痫患者的复发性多发性软骨炎影响气管支气管树,且特征严重。
Pub Date : 2024-02-10 DOI: 10.1016/j.redare.2024.02.004
E Sarrió Badenes, M Durá Aranda, L Molero Sala, P Martín Serrano
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引用次数: 0
Sepsis due to liver abscess diagnosed by ultrasound in the ICU. 在重症监护室通过超声波诊断出肝脓肿引起的败血症。
Pub Date : 2024-02-10 DOI: 10.1016/j.redare.2024.02.008
J F Muñoz Moreno, E Rubio Prieto, A Peral Santos, L Segovia García de Marina
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引用次数: 0
Why is my anaesthesia machine detecting halothane after bronchodilator administration? A curious fact. 为什么我的麻醉机在使用支气管扩张剂后检测到氟烷?一个奇怪的事实
Pub Date : 2024-02-10 DOI: 10.1016/j.redare.2024.02.009
Manuel López-Baamonde, Antonio López-Hernández, Juan Perdomo Linares, Eva Rivas
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引用次数: 0
Transorbital intubation in a patient with difficult airway due to previous surgery. 为一名因既往手术导致气道困难的患者进行经眶插管。
Pub Date : 2024-02-10 DOI: 10.1016/j.redare.2024.02.003
M E Navío Poussivert, A Martinez-Garcia, M I de la Rosa Jiménez
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引用次数: 0
Ceftriaxone-induced Kounis syndrome: A case report and review of the literature 头孢曲松诱发的库尼斯综合征:病例报告和文献综述
Pub Date : 2024-02-01 DOI: 10.1016/j.redare.2023.01.005
S. Ali, M. Athar, R. Rahman, F. Rehman

Kounis syndrome is defined as cardiovascular symptoms that occur secondary to allergic or hypersensitivity insults, and is also called allergic angina and allergic myocardial infarction. We report a case of pre-operative ceftriaxone-induced Kounis syndrome with no evident dermatological manifestation, and describe our diagnostic dilemma. The patient was symptomatically managed and discharged in stable condition with a warning against future use of ceftriaxone.

库尼斯综合征是指继发于过敏性或超敏性损伤的心血管症状,也称为过敏性心绞痛和过敏性心肌梗死。我们报告了一例术前头孢曲松诱发的库尼斯综合征病例,该病例无明显皮肤病表现,并描述了我们的诊断困境。患者经过对症处理后病情稳定出院,并被警告今后不得再使用头孢曲松。
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引用次数: 0
New challenges for Spanish publications in anesthesiology in the new era 新时代西班牙麻醉学出版物面临的新挑战。
Pub Date : 2024-02-01 DOI: 10.1016/j.redare.2024.01.007
A. Abad-Gurumeta
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引用次数: 0
Sedation with propofol/remifentanil versus dexmedetomidine / remifentanil for patients undergoing transcatheter aortic valve implant: A retrospective study between 2012 and 2019 对接受经导管主动脉瓣植入术的患者使用异丙酚/瑞芬太尼镇静与右美托咪定/瑞芬太尼镇静的对比:2012年至2019年的回顾性研究
Pub Date : 2024-02-01 DOI: 10.1016/j.redare.2023.12.003
B. Hernando Vela , P. Jarén Cubillo , C. Bueno Fernández , L. Gallego Ligorit , M.C. Ferrer García , J.A. Diarte

Background and objectives

Percutaneous implantation of an aortic valve prosthesis is a therapeutic alternative for patients with severe aortic stenosis. The procedure is traditionally performed under general anaesthesia; however, sedation is now gaining in popularity because it reduces the need for vasoactive drugs and shortens the patient’s stay in the critical care unit and on the ward. The aim of this study is to evaluate the clinical efficacy, safety and potential benefits of sedation with dexmedetomidine in patients undergoing percutaneous implantation of an aortic valve prosthesis in terms of haemodynamic and respiratory complications.

Materials and methods

We performed a retrospective study of 222 patients that had undergone percutaneous implantation of an aortic valve prosthesis between 2012 and 2019 under sedation with either dexmedetomidine plus remifentanil (DEX-RMF) or propofol plus remifentanil (PROPO-RMF). We collected data on complications, mainly haemodynamic and respiratory, during and after the procedure.

Results

No significant differences were found between sedation with dexmedetomidine and propofol (in combination with remifentanil) in terms of haemodynamic stability and intraprocedural cerebral blood oxygen. In the DEX-RMF group, however, mean blood pressure, midazolam dose, and duration of anaesthesia were lower compared with the PROPO-RMF group, but the incidence of haemodynamic and respiratory complications did not differ significantly between groups.

Conclusions

Our results show that sedation, particularly with adjuvant dexmedetomidine, is a valid anaesthetic techniques in percutaneous aortic valve prosthesis implantation.

背景和目的经皮主动脉瓣假体植入术是重度主动脉瓣狭窄患者的一种治疗选择。该手术传统上在全身麻醉的情况下进行,但现在镇静剂越来越受欢迎,因为它减少了对血管活性药物的需求,缩短了患者在重症监护室和病房的逗留时间。本研究旨在评估使用右美托咪定镇静的临床疗效、安全性以及在主动脉瓣假体经皮植入术患者血液动力学和呼吸系统并发症方面的潜在益处。材料和方法我们对 2012 年至 2019 年期间接受经皮植入主动脉瓣假体手术的 222 例患者进行了回顾性研究,这些患者在使用右美托咪定加瑞芬太尼(DEX-RMF)或丙泊酚加瑞芬太尼(PROPO-RMF)镇静的情况下接受了手术。结果 在血流动力学稳定性和术中脑血氧方面,右美托咪定和丙泊酚(与瑞芬太尼联用)镇静剂之间没有发现明显差异。然而,DEX-RMF 组的平均血压、咪达唑仑剂量和麻醉持续时间均低于 PROPO-RMF 组,但血流动力学和呼吸系统并发症的发生率在各组之间没有显著差异。结论我们的结果表明,镇静,尤其是使用右美托咪定辅助镇静,是经皮主动脉瓣假体植入术中有效的麻醉技术。
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引用次数: 0
Intraoperative high flow oxygen therapy for tubeless anaesthesia in thoracoscopic surgery 胸腔镜手术无管麻醉的术中高流量氧气疗法。
Pub Date : 2024-02-01 DOI: 10.1016/j.redare.2024.01.004
R. Mato-Bua , D. Lopez-Lopez , A. Garcia-Perez , C. Bonome

Tubeless anaesthesia has become widespread in videothoracoscopic surgery, even in major procedures such as lobectomies. There are several advantages in avoiding general anaesthesia and one-lung mechanical ventilation, such as faster recovery and shorter hospital stays. However, hypoxaemia and hypercapnia are the most reported causes of conversion to general anaesthesia. High Flow Oxygen Therapy (HFOT) generates flow-dependent positive end-expiratory pressure, improves oxygenation and also carbon dioxide washout by flow-dependent dead space flushing. For this reason, intraoperative HFOT may reduce the rate of conversion to general anaesthesia. We report our experience with intraoperative HFOT in a 71-year-old female with lung adenocarcinoma undergoing VATS upper left lobectomy.

无管麻醉已广泛应用于视频胸腔镜手术,甚至是肺叶切除等大型手术。避免全身麻醉和单肺机械通气有很多好处,例如恢复更快、住院时间更短。然而,低氧血症和高碳酸血症是导致转为全身麻醉的最主要原因。高流量氧气疗法(HFOT)可产生流量依赖性呼气末正压,改善氧合,并通过流量依赖性死腔冲洗改善二氧化碳排出。因此,术中 HFOT 可以降低全身麻醉的转换率。我们报告了对一名 71 岁女性肺腺癌患者进行 VATS 左上肺叶切除术的术中 HFOT 经验。
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引用次数: 0
Guidelines for inhaled sedation in the ICU 重症监护病房吸入镇静剂指南。
Pub Date : 2024-02-01 DOI: 10.1016/j.redare.2024.01.010
F. García-Montoto , D. Paz-Martín , D. Pestaña , M. Soro , J.M. Marcos Vidal , R. Badenes , A. Suárez de la Rica , T. Bardi , A. Pérez-Carbonell , C. García , J.A. Cervantes , M.P. Martínez , J.L. Guerrero , J.V. Lorente , J. Veganzones , M. Murcia , F.J. Belda

Introduction and objectives

Sedation is used in intensive care units (ICU) to improve comfort and tolerance during mechanical ventilation, invasive interventions, and nursing care. In recent years, the use of inhalation anaesthetics for this purpose has increased.

Our objective was to obtain and summarise the best evidence on inhaled sedation in adult patients in the ICU, and use this to help physicians choose the most appropriate approach in terms of the impact of sedation on clinical outcomes and the risk-benefit of the chosen strategy.

Methodology

Given the overall lack of literature and scientific evidence on various aspects of inhaled sedation in the ICU, we decided to use a Delphi method to achieve consensus among a group of 17 expert panellists. The processes was conducted over a 12-month period between 2022 and 2023, and followed the recommendations of the CREDES guidelines.

Results

The results of the Delphi survey form the basis of these 39 recommendations - 23 with a strong consensus and 15 with a weak consensus.

Conclusion

The use of inhaled sedation in the ICU is a reliable and appropriate option in a wide variety of clinical scenarios. However, there are numerous aspects of the technique that require further study.

简介和目的:在重症监护病房(ICU)中使用镇静剂是为了在机械通气、侵入性干预和护理过程中提高舒适度和耐受性。近年来,吸入麻醉剂在这方面的使用有所增加。我们的目标是获取并总结有关 ICU 成年患者吸入镇静剂的最佳证据,并以此帮助医生根据镇静剂对临床结果的影响以及所选策略的风险收益选择最合适的方法:鉴于在重症监护室吸入镇静剂的各个方面总体上缺乏文献和科学证据,我们决定采用德尔菲法,让 17 位专家组成员达成共识。该过程在2022年至2023年的12个月期间进行,并遵循了CREDES指南的建议:结果:德尔菲调查的结果构成了这 39 项建议的基础,其中 23 项达成了强烈共识,15 项达成了微弱共识:结论:在重症监护病房使用吸入镇静剂是一种可靠而适当的选择,适用于多种临床情况。然而,该技术还有许多方面需要进一步研究。
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引用次数: 0
Inadvertent cannulation of vertebral artery while central venous catheterization 中心静脉导管插入时不慎插入椎动脉。
Pub Date : 2024-02-01 DOI: 10.1016/j.redare.2024.01.006
R.C. Vela Pascual, A.G. Pizarro Calderón, G. Sánchez Barbé, S. García Ramos
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引用次数: 0
期刊
Revista espanola de anestesiologia y reanimacion
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