Pancreatitis aguda / Acute pancreatitis

Abril 17, 2016. No. 2299

Guía de práctica clínica: tratamiento de la pancreatitis aguda. Clinical practice guideline: management of acute pancreatitis. Greenberg JA, Hsu J, Bawazeer M, Marshall J, Friedrich JO, Nathens A, Coburn N, May GR, Pearsall E, McLeod RS. Can J Surg. 2016 Apr;59(2):128-40. Abstract ABSTRACT: There has been an increase in the incidence of acute pancreatitis reported worldwide. Despite improvements in access to care, imaging and interventional techniques, acute pancreatitis continues to be associated with significant morbidity and mortality. Despite the availability of clinical practice guidelines for the management of acute pancreatitis, recent studies auditing the clinical management of the condition have shown important areas of noncompliance with evidence-based recommendations. This underscores the importance of creating understandable and implementable recommendations for the diagnosis and management of acute pancreatitis. The purpose of the present guideline is to provide evidence-based recommendations for the management of both mild and severe acute pancreatitis as well as the management of complications of acute pancreatitisand of gall stone-induced pancreatitis. PDF Manejo del dolor en pancreatitis aguda. Estudio randomizado controlado Pain treatment in patients with acute pancreatitis: A randomized controlled trial. Gülen B1, Dur A, Serinken M, Karcıoğlu Ö, Sönmez E. Turk J Gastroenterol. 2016 Mar;27(2):192-6. doi: 10.5152/tjg.2015.150398. Abstract BACKGROUND/AIMS: In this study, the analgesic effectiveness of tramadol, a synthetic opioid, was compared with paracetamol and dexketoprofen in adult patients with acute pancreatitis in the emergency department. MATERIALS AND METHODS: Study drugs were similar in color and appearance, enabling the patients to be blind to the intervention. Study patients were intravenously administered 1 g paracetamol, 50 mg dexketoprofen trometamol, or 1 mg/kg tramadol with 100 mL normal saline with a 4-5 min infusion. Pain measurements of the patients were conducted at baseline and 30 min after the treatment intervention. Changes in pain scores were calculated by subtracting the median scores at baseline and 30 min as pairs. RESULTS: In this study, 90 patients were enrolled and included in the final analysis. The study subjects had a mean age of 53.5±13.3 years and 58.9% (n=53) of them were male. Gallstones and biliary etiology for pancreatitis was documented in 73.3% (n=66) of patients. Mean VAS scores at baseline and 30 min were similar in the three groups. Similarly, the change of scores from the baseline to the 30th minute did not differ among the groups. Comparison of pain improvements failed to reveal any differences among groups. CONCLUSION: Intravenous paracetamol, dexketoprofen, and tramadol are not superior to each other in the management of pain caused by nontraumatic acute pancreatitis. PDF Pancreatitis inducida por hipertrigliceridemia en el embarazo como causa de muerte materna Hypertriglyceridemia-induced acute pancreatitis in pregnancy causing maternal death. Jeon HR1, Kim SY1, Cho YJ1, Chon SJ1. Obstet Gynecol Sci. 2016 Mar;59(2):148-51. doi: 10.5468/ogs.2016.59.2.148. Epub 2016 Mar 16. Abstract Acute pancreatitis in pregnancy is rare and occurs in approximately 3 in 10,000 pregnancies. It rarely complicates pregnancy, and can occur during any trimester, however over half (52%) of cases occur during the third trimester and during the post-partum period. Gallstones are the most common cause of acute pancreatitis. On the other hand, acute pancreatitis caused by hypertriglyceridemia due to increase of estrogen during the gestational period is very unusual, but complication carries a higher risk of morbidity and mortality for both the mother and the fetus. We experienced a case of pregnant woman who died of acute exacerbation of hypertriglyceridemia-induced acute pancreatitis at 23 weeks of gestation. We report on progress and management of this case along with literature reviews. KEYWORDS: Acute pancreatitis; Hypertriglyceridemia; Maternal death; Pregnancy PDF Committee for European Education in Anaesthesiology (CEEA) Colegio de Anestesiólogos de León AC MÓDULO V: Sistema nervioso, fisiología, anestesia locoregional y dolor. Reconocimientos de: CEEA, CLASA, Consejo Nacional Mexicano de Anestesiología.   En la Ciudad de Léon, Guanajuato. México del 6 al 8 de Mayo, 2016. Informes en el tel (477) 716 06 16 y con el Dr. Enrique Hernández kikinhedz@gmail.com

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Revistas con acceso abierto / Open access journals

Abril 15, 2016. No. 2297   Estimad@ Dr@ Víctor Valdés:

British Journal of Pain  May 2016  Revista / Journal Indian J of Critical Care April 2016; Volume 20 | Issue 4 Page Nos. 207-256 Revista / Journal Pediatric Critical Care Medicine June 2015 - Volume 16 - Supplement 1 5_suppl, pp: S1-S131 Revista / Journal European J of Anaesthesiology January 2014 - Volume 31 - Issue 1 Revista / Journal European J of Anaesthesiology April 2013 - Volume 30 - Issue 4;pp: 139-194 Revista / Journal Current Opinion in Anesthesiology February 2013 - Volume 26 - Issue 1;pp: v-vi,1-104 Revista / Journal Committee for European Education in Anaesthesiology (CEEA) Colegio de Anestesiólogos de León AC MÓDULO V: Sistema nervioso, fisiología, anestesia locoregional y dolor. Reconocimientos de: CEEA, CLASA, Consejo Nacional Mexicano de Anestesiología.   En la Ciudad de Léon, Guanajuato. México del 6 al 8 de Mayo, 2016. Informes en el tel (477) 716 06 16 y con el Dr. Enrique Hernández. kikinhedz@gmail.com

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Anestesia cardiaca / Cardiac anaesthesia

Abril 14, 2016. No. 2296

Lactato, endotelina y saturación venosa central como predictores de mortalidad en pacientes con tetralogía de Fallot Lactate, endothelin, and central venous oxygen saturation as predictors of mortality in patients with Tetralogy of Fallot. Kapoor PM, Dhawan I, Jain P, Chowdhury U. Ann Card Anaesth. 2016 Apr-Jun;19(2):269-76. doi: 10.4103/0971-9784.179619. Abstract BACKGROUND: Lactate and central venous oxygen saturation (ScVO2) are well known biomarkers for adequacy of tissue oxygenation. Endothelin, an inflammatory marker has been associated with patient's nutritional status and degree of cyanosis. The aim of this study was to explore the hypothesis that lactate, ScVO2 and endothelin before induction may be predictive of mortality in pediatric cardiac surgery. METHODS: We conducted a prospective observational study of 150 pediatric (6 months to 12 years) patients who were posted for intracardiac repair for tetralogy of fallot and measured lactate, ScVO2 and endothelin before induction (T1), 20 minutes after protamine administration (T2) and 24 hours after admission to ICU (T3). RESULTS: Preinduction lactate and endothelin levels were found to predict mortality in patients of tetralogy of fallot with an odds ratio of 6.020 (95% CI 2.111-17.168) and 1.292(95% CI 1.091-1.531) respectively. In the ROC curve analysis for lactate at T1, the AUC was 0.713 (95% CI 0.526-0.899 P = 0.019). At the cutoff value of 1.750mmol/lt, the sensitivity and specificity for the prediction of mortality was 63.6% and 65.5%, respectively. For endothelin at T1, the AUC was 0.699 (95% CI 0.516-0.883, P = 0.028) and the cutoff value was ≤2.50 (sensitivity, 63.6%; specificity, 58.3 %). ScVO2 (odds ratio 0.85) at all three time intervals, suggested that improving ScVO2 can lead to 15% reduction in mortality. CONCLUSIONS: Lactate, ScVO2 and endothelin all showed association with mortality with lactate having the maximum prediction. Lactate was found to be an independent, reliable and cost-effective measure of prediction of mortality in patients with tetralogy of fallot. PDF Cuidado postanestésico especializado mejora el manejo fast-track en cirugía cardiaca. Estsudio prospectivo randomizado A specialized post anaesthetic care unit improves fast-track management in cardiac surgery: a prospective randomized trial. Probst S, Cech C, Haentschel D, Scholz M, Ender J. Crit Care. 2014 Aug 15;18(4):468. doi: 10.1186/s13054-014-0468-2. Abstract INTRODUCTION: Fast-track treatment in cardiac surgery has become the global standard of care. We compared the efficacy and safety of a specialised post-anaesthetic care unit (PACU) to a conventional intensive care unit (ICU) in achieving defined fast-track end-points in adult patients after elective cardiac surgery..... CONCLUSIONS: Treatment in a specialised PACU rather than an ICU, after elective cardiac surgery leads to earlier extubation and quicker discharge to a step down unit, without compromising patient safety. PDF Tiamina como terapia adjunta en cirugía cardiaca. Estudio randomizado, doble ciego, placebo controlado, de fase II Thiamine as an adjunctive therapy in cardiac surgery: a randomized, double-blind, placebo-controlled, phase II trial. Andersen LW1,2,3, Holmberg MJ4,5, Berg KM6, Chase M4, Cocchi MN4,7, Sulmonte C4, Balkema J4, MacDonald M4, Montissol S4, Senthilnathan V8, Liu D8,Khabbaz K8, Lerner A9, Novack V10,11, Liu X4, Donnino MW4,6. Crit Care. 2016 Mar 14;20(1):92. doi: 10.1186/s13054-016-1245-1. Abstract BACKGROUND: Thiamine is a vitamin that is essential for adequate aerobic metabolism. The objective of this study was to determine if thiamine administration prior to coronary artery bypass grafting would decrease post-operative lactate levels as a measure of increased aerobic metabolism.... CONCLUSIONS: There were no differences in post-operative lactate levels or clinical outcomes between patients receiving thiamine or placebo. Post-operative oxygen consumption was significantly increased among patients receiving thiamine. PDF Committee for European Education in Anaesthesiology (CEEA) Colegio de Anestesiólogos de León AC MÓDULO V: Sistema nervioso, fisiología, anestesia locoregional y dolor. Reconocimientos de: CEEA, CLASA, Consejo Nacional Mexicano de Anestesiología.   En la Ciudad de Léon, Guanajuato. México del 6 al 8 de Mayo, 2016. Informes en el tel (477) 716 06 16 y con el Dr. Enrique Hernández kikinhedz@gmail.com

Anestesiología y Medicina del Dolor 52 664 6848905 vwhizar@anestesia-dolor.org anestesia-dolor.org Copyright © 2015