Pub Date : 2024-05-01DOI: 10.1016/j.redare.2024.02.031
M. Astete , H.J. Lacassie
The main causes of maternal mortality are comorbidities, hypertensive pregnancy syndrome, obstetric haemorrhage, and maternal sepsis. For this reason, uterotonics, magnesium sulphate, and antibiotics are essential tools in the management of obstetric patients during labour and in the peripartum period. These drugs are widely used by anaesthesiologists in all departments, and play a crucial role in treatment and patient safety.
For the purpose of this narrative review, we performed a detailed search of medical databases and selected studies describing the use of these drugs in patients during pregnancy, delivery and the pospartum period.
Uterotonics, above all oxytocin, play an important role in the prevention and treatment of pospartum haemorrhage, and various studies have shown that in obstetric procedures, such as scheduled and emergency caesarean section, they are effective at lower doses than those hitherto accepted. We also discuss the use of carbetocin as an effective alternative that has a therapeutic advantage in certain clinical circumstances.
Magnesium sulphate is the gold standard in the prevention and treatment of eclampsia, and also plays a neuroprotective role in preterm infants. We describe the precautions to be taken during magnesium administration.
Finally, we discuss the importance of understanding microbiology and the pharmacology of antibiotics in the management of obstetric infection and endometritis, and draw attention to the latest trends in antibiotic regimens in labour and caesarean section.
{"title":"Uterotonics, magnesium sulphate and antibiotics during childbirth and peripartum: Important obstetric drugs for the anaesthesiologist","authors":"M. Astete , H.J. Lacassie","doi":"10.1016/j.redare.2024.02.031","DOIUrl":"10.1016/j.redare.2024.02.031","url":null,"abstract":"<div><p>The main causes of maternal mortality are comorbidities, hypertensive pregnancy syndrome, obstetric haemorrhage, and maternal sepsis. For this reason, uterotonics, magnesium sulphate, and antibiotics are essential tools in the management of obstetric patients during labour and in the peripartum period. These drugs are widely used by anaesthesiologists in all departments, and play a crucial role in treatment and patient safety.</p><p>For the purpose of this narrative review, we performed a detailed search of medical databases and selected studies describing the use of these drugs in patients during pregnancy, delivery and the pospartum period.</p><p>Uterotonics, above all oxytocin, play an important role in the prevention and treatment of pospartum haemorrhage, and various studies have shown that in obstetric procedures, such as scheduled and emergency caesarean section, they are effective at lower doses than those hitherto accepted. We also discuss the use of carbetocin as an effective alternative that has a therapeutic advantage in certain clinical circumstances.</p><p>Magnesium sulphate is the gold standard in the prevention and treatment of eclampsia, and also plays a neuroprotective role in preterm infants. We describe the precautions to be taken during magnesium administration.</p><p>Finally, we discuss the importance of understanding microbiology and the pharmacology of antibiotics in the management of obstetric infection and endometritis, and draw attention to the latest trends in antibiotic regimens in labour and caesarean section.</p></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140013883","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 : 2024-05-01DOI: 10.1016/j.redare.2024.02.013
R.M. Sarhan, M.S. Boshra, M.E.A. Abdelrahim, H. Osama
Background
We performed a meta-analysis to assess the effectiveness and safety of tranexamic acid in patients with traumatic brain injury (TBI).
Methods
We searched the literature for articles evaluating the effectiveness and safety of tranexamic acid (TXA) in TBI published between January 2012 and January 2021, and identified 8 studies with a total of 10860 patients: 5660 received TXA and 5200 served as controls. We used a dichotomous or continuous approach with a random or fixed-effect model to assess the efficacy and safety of TXA in TBI, and calculated the mean difference (MD) and odds ratio (OR) with the corresponding 95% confidence interval.
Results
In patients with TBI, early administration of TXA was associated with a greater relative benefit (MD −2.45; 95% CI = −4.78 to −0.12; p = 0.04) and less total haematoma expansion (MD - 2.52; 95% CI = −4.85 to −0.19; p = 0.03) compared to controls.
There were no statistically significant differences in mortality (OR 0.94; 95% CI = 0.85–1.03; p = 0.18), presence of progressive haemorrhage (OR 0.75; 95% CI = 0.56–1.01; p = 0.06), need for neurosurgery (OR 1.15; 95% CI = 0.66–1.98; p = 0.63), high Disability Rating Scale score (OR 0.90; 95% CI = 0.56–1.45; p = 0.68), and incidence of ischaemic or thromboembolic complications (OR 1.34; 95% CI = 0.33–5.46; p = 0.68) between TBI patients treated with TXA and controls.
Conclusions
Early administration of TXA in TBI patients may have a greater relative benefit and may inhibit haematoma expansion. There were no significant differences in mortality, presence of progressive haemorrhage, need for neurosurgery, high Disability Rating Scale score, and incidence of ischaemic or thromboembolic complications between TBI patients treated with TXA and controls. Further studies are needed to validate these results.
背景:我们进行了一项荟萃分析,以评估氨甲环酸对创伤性脑损伤(TBI)患者的有效性和安全性:我们检索了2012年1月至2021年1月期间发表的评估氨甲环酸(TXA)对创伤性脑损伤的有效性和安全性的文献,并确定了8项研究,共计10860名患者:其中 5660 名患者接受了氨甲环酸治疗,5200 名患者作为对照组。我们采用随机或固定效应模型的二分法或连续法评估了TXA在TBI中的疗效和安全性,并计算了平均差(MD)和几率比(OR)以及相应的95%置信区间:在创伤性脑损伤患者中,与对照组相比,早期给予 TXA 有更大的相对益处(MD -2.45;95% CI = -4.78 至 -0.12;p = 0.04),且血肿扩大的程度较小(MD -2.52;95% CI = -4.85 至 -0.19;p = 0.03)。在死亡率(OR 0.94;95% CI = 0.85-1.03;p = 0.18)、进行性出血(OR 0.75;95% CI = 0.56-1.01;p = 0.06)、神经外科手术需求(OR 1.15;95% CI = 0.66-1.98;p = 0.63)、残疾评定量表评分高(OR 0.90;95% CI = 0.56-1.45;p = 0.68)、缺血或血栓栓塞并发症的发生率(OR 1.34;95% CI = 0.33-5.46;p = 0.68):结论:对创伤性脑损伤患者及早使用TXA可能具有更大的相对益处,并可抑制血肿扩大。接受 TXA 治疗的创伤性脑损伤患者与对照组患者在死亡率、进行性出血、神经外科手术需求、高度残疾评定量表评分以及缺血性或血栓栓塞并发症的发生率方面没有明显差异。需要进一步研究来验证这些结果。
{"title":"Tranexamic acid in patients with traumatic brain injury: a meta-analysis","authors":"R.M. Sarhan, M.S. Boshra, M.E.A. Abdelrahim, H. Osama","doi":"10.1016/j.redare.2024.02.013","DOIUrl":"10.1016/j.redare.2024.02.013","url":null,"abstract":"<div><h3>Background</h3><p>We performed a meta-analysis to assess the effectiveness and safety of tranexamic acid in patients with traumatic brain injury (TBI).</p></div><div><h3>Methods</h3><p>We searched the literature for articles evaluating the effectiveness and safety of tranexamic acid (TXA) in TBI published between January 2012 and January 2021, and identified 8 studies with a total of 10860 patients: 5660 received TXA and 5200 served as controls. We used a dichotomous or continuous approach with a random or fixed-effect model to assess the efficacy and safety of TXA in TBI, and calculated the mean difference (MD) and odds ratio (OR) with the corresponding 95% confidence interval.</p></div><div><h3>Results</h3><p>In patients with TBI, early administration of TXA was associated with a greater relative benefit (MD −2.45; 95% CI = −4.78 to −0.12; p<!--> <!-->=<!--> <!-->0.04) and less total haematoma expansion (MD - 2.52; 95% CI = −4.85 to −0.19; p<!--> <!-->=<!--> <!-->0.03) compared to controls.</p><p>There were no statistically significant differences in mortality (OR 0.94; 95% CI<!--> <!-->=<!--> <!-->0.85–1.03; p<!--> <!-->=<!--> <!-->0.18), presence of progressive haemorrhage (OR 0.75; 95% CI<!--> <!-->=<!--> <!-->0.56–1.01; p<!--> <!-->=<!--> <!-->0.06), need for neurosurgery (OR 1.15; 95% CI<!--> <!-->=<!--> <!-->0.66–1.98; p<!--> <!-->=<!--> <!-->0.63), high Disability Rating Scale score (OR 0.90; 95% CI<!--> <!-->=<!--> <!-->0.56–1.45; p<!--> <!-->=<!--> <!-->0.68), and incidence of ischaemic or thromboembolic complications (OR 1.34; 95% CI<!--> <!-->=<!--> <!-->0.33–5.46; p<!--> <!-->=<!--> <!-->0.68) between TBI patients treated with TXA and controls.</p></div><div><h3>Conclusions</h3><p>Early administration of TXA in TBI patients may have a greater relative benefit and may inhibit haematoma expansion. There were no significant differences in mortality, presence of progressive haemorrhage, need for neurosurgery, high Disability Rating Scale score, and incidence of ischaemic or thromboembolic complications between TBI patients treated with TXA and controls. Further studies are needed to validate these results.</p></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139934948","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 : 2024-05-01DOI: 10.1016/j.redare.2024.02.014
J. Rico-Feijoó , J.F. Bermejo , A. Pérez-González , S. Martín-Alfonso , C. Aldecoa
Background and objective
The diagnosis of infection, to diagnose septic shock, has been qualified by leukocyte counts and protein biomarkers. Septic shock mortality is persistently high (20%–50%), and rising in the long term. The definition of sepsis does not include leukocyte count, and lymphopenia has been associated with its mortality in the short term. Immunosuppression and increased mortality in the long term due to sepsis have not been demonstrated. The aim is to relate the occurrence of lymphopenia and its lack of recovery during septic shock with mortality at 2 years.
Patients and methods
Cohort of 332 elderly patients diagnosed with septic shock. Mortality at 28 days and 2 years was analysed according to leukocyte, neutrophil, and lymphocyte counts, and the ability to recover from lymphopenia (LRec).
Results
A total of 74.1% of patients showed lymphopenia, and 73.5% did not improve during ICU stay. Mortality was 31.0% and 50.3% at 28 days and 2 years, respectively. Lymphopenia was a predictor of early mortality (OR 2.96) and LRec of late mortality (OR 3.98). Long-term mortality was associated with LRec (HR 1.69).
Conclusions
In elderly patients with septic shock, 28-day mortality is associated with lymphopenia and neutrophilia, and LRec with 2-year mortality; this may represent 2 distinct phenotypes of behaviour after septic shock.
{"title":"Influence of lymphopenia on long-term mortality in septic shock, a retrospective observational study","authors":"J. Rico-Feijoó , J.F. Bermejo , A. Pérez-González , S. Martín-Alfonso , C. Aldecoa","doi":"10.1016/j.redare.2024.02.014","DOIUrl":"10.1016/j.redare.2024.02.014","url":null,"abstract":"<div><h3>Background and objective</h3><p>The diagnosis of infection, to diagnose septic shock, has been qualified by leukocyte counts and protein biomarkers. Septic shock mortality is persistently high (20%–50%), and rising in the long term. The definition of sepsis does not include leukocyte count, and lymphopenia has been associated with its mortality in the short term. Immunosuppression and increased mortality in the long term due to sepsis have not been demonstrated. The aim is to relate the occurrence of lymphopenia and its lack of recovery during septic shock with mortality at 2 years.</p></div><div><h3>Patients and methods</h3><p>Cohort of 332 elderly patients diagnosed with septic shock. Mortality at 28 days and 2 years was analysed according to leukocyte, neutrophil, and lymphocyte counts, and the ability to recover from lymphopenia (LRec).</p></div><div><h3>Results</h3><p>A total of 74.1% of patients showed lymphopenia, and 73.5% did not improve during ICU stay. Mortality was 31.0% and 50.3% at 28 days and 2 years, respectively. Lymphopenia was a predictor of early mortality (OR 2.96) and LRec of late mortality (OR 3.98). Long-term mortality was associated with LRec (HR 1.69).</p></div><div><h3>Conclusions</h3><p>In elderly patients with septic shock, 28-day mortality is associated with lymphopenia and neutrophilia, and LRec with 2-year mortality; this may represent 2 distinct phenotypes of behaviour after septic shock.</p></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139935122","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 : 2024-05-01DOI: 10.1016/j.redare.2024.02.012
A. González-Castro, A. Fernandez, E. Cuenca-Fito, Y. Peñasco, J. Ceña, J.C. Rodríguez Borregán
Introduction
During the SARS-CoV-2 pandemic, several corticosteroid regimens have been used in the treatment of the disease, with disparate results according to drug and regimen used. For this reason, we wanted to analyze differences in early mortality derived from the use of different regimens of dexamethasone and methylprednisolone in SARS-CoV-2 infection in critically ill patients requiring admission to an ICU.
Method
Observational, analytical and retrospective study, in an intensive care unit of a third-level university hospital, (March 2020 and June 2021). Adult patients (>18 years old) who were admitted consecutively for proven SARS-CoV-2 infection were included. The association with mortality in ICU at 28 days, different corticosteroid regimens used, was analyzed using a Cox proportional risk regression model.
Results
Data from a cohort of 539 patients were studied. Patient age (RR: 1.06; 95% CI: 1.02–1.10; P = <0.01) showed a significant association with 28-day mortality in the ICU. In the comparison of the different corticosteroid regimens analyzed, taking as a reference those patients who did not receive corticosteroid treatment, the dose of dexamethasone of 6 mg/day showed a clear trend towards statistical significance as a protector of mortality at 28 days in the ICU (RR: 0.40, 95% CI: 0.15–1.02, p = 0.05). The dose of dexamethasone of 6 mg/day and low doses of methylprednisolone show a similar association with survival at 28 days (OR: 1.19; 95% CI: 0.63–2.26).
Conclusions
The use of corticosteroids has been associated with better mortality outcomes in severe cases of SARS-CoV-2 infection. However, the therapeutic benefits of corticosteroids are not limited to dexamethasone alone.
{"title":"Association between different corticosteroid regimens used in severe SARS-CoV-2 infection and short-term mortality: retrospective cohort study","authors":"A. González-Castro, A. Fernandez, E. Cuenca-Fito, Y. Peñasco, J. Ceña, J.C. Rodríguez Borregán","doi":"10.1016/j.redare.2024.02.012","DOIUrl":"10.1016/j.redare.2024.02.012","url":null,"abstract":"<div><h3>Introduction</h3><p>During the SARS-CoV-2 pandemic, several corticosteroid regimens have been used in the treatment of the disease, with disparate results according to drug and regimen used. For this reason, we wanted to analyze differences in early mortality derived from the use of different regimens of dexamethasone and methylprednisolone in SARS-CoV-2 infection in critically ill patients requiring admission to an ICU.</p></div><div><h3>Method</h3><p>Observational, analytical and retrospective study, in an intensive care unit of a third-level university hospital, (March 2020 and June 2021). Adult patients (>18 years old) who were admitted consecutively for proven SARS-CoV-2 infection were included. The association with mortality in ICU at 28 days, different corticosteroid regimens used, was analyzed using a Cox proportional risk regression model.</p></div><div><h3>Results</h3><p>Data from a cohort of 539 patients were studied. Patient age (RR: 1.06; 95% CI: 1.02–1.10; <em>P</em> <!-->=<!--> <!--><0.01) showed a significant association with 28-day mortality in the ICU. In the comparison of the different corticosteroid regimens analyzed, taking as a reference those patients who did not receive corticosteroid treatment, the dose of dexamethasone of 6<!--> <!-->mg/day showed a clear trend towards statistical significance as a protector of mortality at 28 days in the ICU (RR: 0.40, 95% CI: 0.15–1.02, p<!--> <!-->=<!--> <!-->0.05). The dose of dexamethasone of 6<!--> <!-->mg/day and low doses of methylprednisolone show a similar association with survival at 28 days (OR: 1.19; 95% CI: 0.63–2.26).</p></div><div><h3>Conclusions</h3><p>The use of corticosteroids has been associated with better mortality outcomes in severe cases of SARS-CoV-2 infection. However, the therapeutic benefits of corticosteroids are not limited to dexamethasone alone.</p></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139941405","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 : 2024-05-01DOI: 10.1016/j.redare.2024.02.022
M. de la Matta , J.M. Delgado-Sánchez , G. Martín-Gutiérrez
{"title":"In reply to “Negative preoperative RT-PCR screening is no guaranty of no SARS-CoV-2 infection”","authors":"M. de la Matta , J.M. Delgado-Sánchez , G. Martín-Gutiérrez","doi":"10.1016/j.redare.2024.02.022","DOIUrl":"10.1016/j.redare.2024.02.022","url":null,"abstract":"","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139998753","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 : 2024-05-01DOI: 10.1016/j.redare.2024.02.029
L. Quecedo Gutierrez , E. Alsina , B. del Blanco Narciso , A. Vazquez Lima , M. Zaballos Garcia , A. Abad Gurumeta
Introduction and objectives
Cataract surgery is one of the most common procedures in outpatient surgery units. The use of information and communication technologies (ICT) in clinical practice and the advent of new health scenarios, such as the Covid pandemic, have driven the development of pre-anaesthesia assessment models that free up resources to improve access to cataract surgery without sacrificing patient safety. The approach to cataract surgery varies considerably among public, subsidised and private hospitals. This raises the need for guidelines to standardise patient assessment, pre-operative tests, management of background medication, patient information and informed consent.
Results
In this document, the SEDAR Clinical Management Division together with the Major Outpatient Surgery Division SEDAR Working Group put forward a series of consensus recommendations on pre-anaesthesia testing based on the use of ITCs, health questionnaires, patient information and informed consent supervised and evaluated by an anaesthesiologist.
Conclusions
This consensus document will effectivise pre-anaesthesia assessment in cataract surgery while maintaining the highest standards of quality, safety and legality.
{"title":"Pre-anaesthesia assessment in cataract surgery: Recommendations from the SEDAR Working Group","authors":"L. Quecedo Gutierrez , E. Alsina , B. del Blanco Narciso , A. Vazquez Lima , M. Zaballos Garcia , A. Abad Gurumeta","doi":"10.1016/j.redare.2024.02.029","DOIUrl":"10.1016/j.redare.2024.02.029","url":null,"abstract":"<div><h3>Introduction and objectives</h3><p>Cataract surgery is one of the most common procedures in outpatient surgery units. The use of information and communication technologies (ICT) in clinical practice and the advent of new health scenarios, such as the Covid pandemic, have driven the development of pre-anaesthesia assessment models that free up resources to improve access to cataract surgery without sacrificing patient safety. The approach to cataract surgery varies considerably among public, subsidised and private hospitals. This raises the need for guidelines to standardise patient assessment, pre-operative tests, management of background medication, patient information and informed consent.</p></div><div><h3>Results</h3><p>In this document, the SEDAR Clinical Management Division together with the Major Outpatient Surgery Division SEDAR Working Group put forward a series of consensus recommendations on pre-anaesthesia testing based on the use of ITCs, health questionnaires, patient information and informed consent supervised and evaluated by an anaesthesiologist.</p></div><div><h3>Conclusions</h3><p>This consensus document will effectivise pre-anaesthesia assessment in cataract surgery while maintaining the highest standards of quality, safety and legality.</p></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2341192924000519/pdfft?md5=e27d36e8efcf14baa8a4b48b1ecc42ae&pid=1-s2.0-S2341192924000519-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140013881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-01DOI: 10.1016/j.redare.2023.11.004
J. Finsterer
{"title":"Before diagnosing a SARS-CoV-2-related PRES, alternative diagnoses must be ruled out","authors":"J. Finsterer","doi":"10.1016/j.redare.2023.11.004","DOIUrl":"10.1016/j.redare.2023.11.004","url":null,"abstract":"","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138441916","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 : 2024-05-01DOI: 10.1016/j.redare.2023.12.008
Salvatore Chirumbolo
{"title":"SARS-CoV-2 RT-PCR in the absence of reference standards cannot warrant for a reliable analytical performance","authors":"Salvatore Chirumbolo","doi":"10.1016/j.redare.2023.12.008","DOIUrl":"10.1016/j.redare.2023.12.008","url":null,"abstract":"","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139038365","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 : 2024-05-01DOI: 10.1016/j.redare.2023.12.009
A. Ojeda , A. Calvo , T. Cuñat , R. Mellado-Artigas , A. Costas-Carrera , M.M. Sánchez-Rodriguez , O. Comino-Trinidad , J. Aliaga , M. Arias , G. Martínez-Pallí , C. Dürsteler , C. Ferrando
Background
Critical COVID-19 survivors are at risk of developing Post-intensive Care Syndrome (PICS) and Chronic ICU-Related Pain (CIRP). We determined whether a specific care program improves the quality of life (QoL) of patients at risk of developing PICS and CIRP after COVID-19.
Methods
The PAIN-COVID trial was a parallel-group, single-centre, single-blinded, randomized controlled trial. The intervention consisted of a follow up program, patient education on PICS and pain, and a psychological intervention based on Rehm’s self-control model in patients with abnormal depression scores (≥8) in the Hospital Anxiety and Depression Scale (HADS) at the baseline visit. QoL was evaluated with the 5-level EQ 5D (EQ 5D 5 L), mood disorders with the HADS, post-traumatic stress disorder (PTSD) with the PCL-5 checklist, and pain with the Brief Pain Inventory short form, the Douleur Neuropathique 4 questionnaire, and the Pain Catastrophizing Scale. The primary outcome was to determine if the program was superior to standard-of-care on the EQ visual analogue scale (VAS) at 6 months after the baseline visit. The secondary outcomes were EQ VAS at 3 months, and EQ index, CIRP incidence and characteristics, and anxiety, depression, and PTSD at 3 and 6 months after baseline visits.
Conclusions
This program was not superior to standard care in improving QoL in critical COVID-19 survivors as measured by the EQ VAS. However, our data can help establish better strategies for the study and management of PICS and CIRP in this population.
{"title":"Effectiveness of a specific follow up program for the management of the mental components of post-intensive care syndrome and chronic pain after COVID-19: results from the PAIN-COVID randomized clinical trial","authors":"A. Ojeda , A. Calvo , T. Cuñat , R. Mellado-Artigas , A. Costas-Carrera , M.M. Sánchez-Rodriguez , O. Comino-Trinidad , J. Aliaga , M. Arias , G. Martínez-Pallí , C. Dürsteler , C. Ferrando","doi":"10.1016/j.redare.2023.12.009","DOIUrl":"10.1016/j.redare.2023.12.009","url":null,"abstract":"<div><h3>Background</h3><p>Critical COVID-19 survivors are at risk of developing Post-intensive Care Syndrome (PICS) and Chronic ICU-Related Pain (CIRP). We determined whether a specific care program improves the quality of life (QoL) of patients at risk of developing PICS and CIRP after COVID-19.</p></div><div><h3>Methods</h3><p>The PAIN-COVID trial was a parallel-group, single-centre, single-blinded, randomized controlled trial. The intervention consisted of a follow up program, patient education on PICS and pain, and a psychological intervention based on Rehm’s self-control model in patients with abnormal depression scores (≥8) in the Hospital Anxiety and Depression Scale (HADS) at the baseline visit. QoL was evaluated with the 5-level EQ 5D (EQ 5D 5 L), mood disorders with the HADS, post-traumatic stress disorder (PTSD) with the PCL-5 checklist, and pain with the Brief Pain Inventory short form, the Douleur Neuropathique 4 questionnaire, and the Pain Catastrophizing Scale. The primary outcome was to determine if the program was superior to standard-of-care on the EQ visual analogue scale (VAS) at 6 months after the baseline visit. The secondary outcomes were EQ VAS at 3 months, and EQ index, CIRP incidence and characteristics, and anxiety, depression, and PTSD at 3 and 6 months after baseline visits.</p></div><div><h3>Conclusions</h3><p>This program was not superior to standard care in improving QoL in critical COVID-19 survivors as measured by the EQ VAS. However, our data can help establish better strategies for the study and management of PICS and CIRP in this population.</p></div><div><h3>Trial registration</h3><p># NCT04394169, registered on 5/19/2020.</p></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139503300","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}