Interacciones corazón-pulmón durante ventilación mecánica / Heart-lung interactions during mechanical ventilation.

Noviembre 13, 2017. No. 2901

Conceptos básicos de las interacciones corazón-pulmón durante la ventilación mecánica. Los pacientes críticamente enfermos con la necesidad de ventilación mecánica muestran interacciones complejas entre la fisiología respiratoria y cardiovascular. Estas interacciones son importantes ya que pueden guiar las decisiones terapéuticas del médico y, posiblemente, afectar el resultado del paciente. El objetivo de la presente revisión es proporcionar al médico en ejercicio una visión general de los conceptos de las interacciones corazón-pulmón durante la ventilación mecánica. Resumimos la fisiología respiratoria y cardíaca básica durante la respiración espontánea y bajo ventilación mecánica. El foco principal está en la interacción entre la ventilación con presión positiva y sus efectos sobre la pre y poscarga del ventrículo derecho e izquierdo y la interdependencia ventricular. Además, discutimos diferentes modalidades para evaluar la capacidad de respuesta del volumen, como la variación de la presión del pulso. Nuestro objetivo es familiarizar al lector con los efectos secundarios cardiovasculares de la ventilación mecánica cuando experimenta problemas de destete o insuficiencia cardíaca derecha. Basic concepts of heart-lung interactions during mechanical ventilation. Grübler MR1, Wigger O1, Berger D2, Blöchlinger S3. Author information Swiss Med Wkly. 2017 Sep 25;147:w14491. doi: 10.4414/smw.2017.14491. eCollection 2017 Sep 25. Abstract Critically ill patients with the need for mechanical ventilation show complex interactions between respiratory and cardiovascular physiology. These interactions are important as they may guide the clinician's therapeutic decisions and, possibly, affect patient outcome. The aim of the present review is to provide the practicing physician with an overview of the concepts of heart-lung interactions during mechanical ventilation. We outline the basic cardiac and respiratory physiology during spontaneous breathing and under mechanical ventilation. The main focus is on the interaction between positive pressure ventilation and its effects on right and left ventricular pre- and afterload and ventricular interdependence. Further we discuss different modalities to assess volume responsiveness, such as pulse pressure variation. We aim to familiarise the reader with cardiovascular side effects of mechanical ventilation when experiencing weaning problems or right heart failure. PDF LI Congreso Mexicano de Anestesiología Mérida Yucatán, Noviembre 21-25, 2017 Información / Information International Anesthesia Research Society Annuals Meetings USA Informes / Information 17h World Congress of Anaesthesiologists, WFSA Prague, Czech Republic, Sep 6-11, 2020 Informes / Information

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Pulmón, fumar y anestesia / Lung, smoking and anesthesia

Febrero 14 2017. No. 2600

Valoración preoperatoria de pacientes con enfermedades pulmonares programados para cirugía no cardiotorácica Perioperative Evaluation of Patients with Pulmonary Conditions Undergoing Non-Cardiothoracic Surgery. Diaz-Fuentes G1, Hashmi HR2, Venkatram S3. Health Serv Insights. 2016 Nov 9;9(Suppl 1):9-23. eCollection 2016. Abstract This review describes the perioperative management of patients with suspected or established pulmonary conditions undergoing non-cardiothoracic surgery, with a focus on common pulmonary conditions such as obstructive airway disease, pulmonary hypertension, obstructive sleep apnea, and chronic hypoxic respiratory conditions. Considering that postoperative pulmonary complications are common and given the increasing number of surgical procedures and the size of the aging population, familiarity with current guidelines for preoperative risk assessment and intra- and postoperative patient management is recommended to decrease the morbidity and mortality. In particular, smoking cessation and pulmonary rehabilitation are perioperative strategies for improving patients' short- and long-term outcomes. Understanding the potential risk for pulmonary complications allows the medical team to appropriately plan the intra- and postoperative care of each patient. KEYWORDS: chronic obstructive pulmonary disease; intraoperative care; obstructive sleep apnea; postoperative complications; pulmonary; pulmonary hypertension PDF Efectos de fumar y dejar de fumar sobre la cirugía de columna. Revisión sistemática de la literatura The Effects of Smoking and Smoking Cessation on Spine Surgery: A Systematic Review of the Literature. Jackson KL 2nd1, Devine JG2. Global Spine J. 2016 Nov;6(7):695-701. Epub 2016 Jan 15. PDF Tabaquismo y Efecto de la Dexmedetomidina y del Fentanil en la Intubación Traqueal Kemal Gulsoy 1, Serpil Deren 1, Semih Baskan 1, Dilsen Ornek 1, Bayazit Dikmen Rev Bras Anestesiol 2012; 62: 2: 141-153 PDF Cese del tabaquismo preoperatorio a corto plazo y complicaciones postoperatorias: revisión sistemática y meta-análisis Short-term preoperative smoking cessation and postoperative complications: a systematic review and meta-analysis. Wong J1, Lam DP, Abrishami A, Chan MT, Chung F. Can J Anaesth. 2012 Mar;59(3):268-79. doi: 10.1007/s12630-011-9652-x. Epub 2011 Dec 21. Abstract PURPOSE: The literature was reviewed to determine the risks or benefits of short-term (less than four weeks) smoking cessation on postoperative complications and to derive the minimum duration of preoperative abstinence from smoking required to reduce such complications in adult surgical patients. SOURCE: We searched MEDLINE, EMBASE, Cochrane, and other relevant databases for cohort studies and randomized controlled trials that reported postoperative complications (i.e., respiratory, cardiovascular, wound-healing) and mortality in patients who quit smoking within six months of surgery. Using a random effects model, meta-analyses were conducted to compare the relative risks of complications in ex-smokers with varying intervals of smoking cessation vs the risks in current smokers. PRINCIPAL FINDINGS: We included 25 studies. Compared with current smokers, the risk of respiratory complications was similar in smokers who quit less than two or two to four weeks before surgery (risk ratio [RR] 1.20; 95% confidence interval [CI] 0.96 to 1.50 vs RR 1.14; CI 0.90 to 1.45, respectively). Smokers who quit more than four and more than eight weeks before surgery had lower risks of respiratory complications than current smokers (RR 0.77; 95% CI 0.61 to 0.96 and RR 0.53; 95% CI 0.37 to 0.76, respectively). For wound-healing complications, the risk was less in smokers who quit more than three to four weeks before surgery than in current smokers (RR 0.69; 95% CI 0.56 to 0.84). Few studies reported cardiovascular complications and there were few deaths. CONCLUSION: At least four weeks of abstinence from smoking reduces respiratory complications, and abstinence of at least three to four weeks reduces wound-healing complications. Short-term (less than four weeks) smoking cessation does not appear to increase or reduce the risk of postoperative respiratory complications. PDF Curso sobre Anestesia en Trasplantes, Cirugía abdominal, Plástica, Oftalmología y Otorrinolaringología. Committee for European Education in Anaesthesiology (CEEA)  y el Colegio de Anestesiólogos de León A.C. Abril 7-9, 2017, León Guanajuato, México Informes  (477) 716 06 16, kikinhedz@gmail.com Regional Anesthesiology and Acute Pain Medicine Meeting April 6-8, 2017, San Francisco, California, USA ASRA American Society of Regional Anesthesia and Pain Medicine Información / Information

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