Sepsis

Abril 20, 2016. No. 2302

Diseño de ensayos fase 3 en sepsis: aplicación de las experiencias adquiridas a partir de ensayos de cuidados críticos en la insuficiencia cardíaca aguda. Designing phase 3 sepsis trials: application of learned experiences from critical care trials in acute heart failure. Mebazaa A1, Laterre PF2, Russell JA3, Bergmann A4, Gattinoni L5, Gayat E6, Harhay MO7, Hartmann O4, Hein F4, Kjolbye AL8, Legrand M9, Lewis RJ10,Marshall JC11, Marx G12, Radermacher P13, Schroedter M4, Scigalla P4, Stough WG14, Struck J4, Van den Berghe G15, Yilmaz MB16, Angus DC17. J Intensive Care. 2016 Mar 31;4:24. doi: 10.1186/s40560-016-0151-6. eCollection 2016. Abstract Substantial attention and resources have been directed to improving outcomes of patients with critical illnesses, in particular sepsis, but all recent clinical trials testing various interventions or strategies have failed to detect a robust benefit on mortality. Acute heart failure is also a critical illness, and although the underlying etiologies differ, acute heart failure and sepsis are critical care illnesses that have a high mortality in which clinical trials have been difficult to conduct and have not yielded effective treatments. Both conditions represent a syndrome that is often difficult to define with a wide variation in patient characteristics, presentation, and standard management across institutions. Referring to past experiences and lessons learned in acute heart failure may be informative and help frame research in the area of sepsis. Academic heart failure investigators and industry have worked closely with regulators for many years to transition acute heart failure trials away from relying on dyspnea assessments and all-cause mortality as the primary measures of efficacy, and recent trials have been designed to assess novel clinical composite endpoints assessing organ dysfunction and mortality while still assessing all-cause mortality as a separate measure of safety. Applying the lessons learned in acute heart failure trials to severe sepsis and septic shock trials might be useful to advance the field. Novel endpoints beyond all-cause mortality should be considered for future sepsis trials. KEYWORDS: Clinical trials as topic; Heart failure; Mortality; Multiple organ failure; Sepsis 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

Dexmedetomidina

Abril 22, 2016. No. 2304

Dexmedetomidina-fentanil comparados con midazolam-fentanil en sedación consciente en pacientes programados para cirugía de los discos lumbares Dexmedetomidine-fentanyl Compared With Midazolam-fentanyl for Conscious Sedation in Patients Undergoing Lumbar Disc Surgery. Peng K1, Liu HY1, Liu SL1, Ji FH2. Clin Ther. 2016 Jan 1;38(1):192-201.e2. doi: 10.1016/j.clinthera.2015.11.016. Epub 2015 Dec 14. Abstract PURPOSE: Patients undergoing awake lumbar disc surgery need adequate sedation and analgesia. This study investigated whether use of a dexmedetomidine-fentanyl (DF) regimen could be superior to midazolam-fentanyl (MF) for these patients. METHODS: Sixty patients scheduled for elective lumbar laminotomy and discectomy were randomly assigned to receive either DF or MF for conscious sedation. Patient-controlled intravenous analgesia with fentanyl was used for postoperative pain management. Hemodynamic and respiratory changes, sedation scores, pain scores, fentanyl consumption, patient satisfaction, postoperative hospital stay, and adverse events were assessed. FINDINGS: The patient and surgical characteristics, sedation levels, and pain scores were similar in the 2 groups. Compared with the MF group, heart rate was lower in the DF group at six time points from skin incision to 15 minutes in the postanesthesia care unit (PACU), they are skin incision, 15 min after the beginning of surgery, 30 min after the beginning of surgery, skin closure, entering PACU, and 15 min in PACU (P = 0.016, 0.002, 0.000, 0.000, 0.000, and 0.001, respectively), whereas pulse oxygen saturation was higher at 3 time points from 15 minutes after the beginning of surgery to skin closure (P = 0.022, 0.026, and 0.025, respectively). The intraoperative, postoperative, and total consumption of fentanyl were lower in the DF group (total: mean difference = -69.3 µg; 95% CI, = -114.3 to -24.4; P = 0.003). No significant differences were found for adverse events, postoperative hospital stay, or satisfaction between the 2 groups. IMPLICATIONS: Although awake lumbar disc surgery can be performed successfully under sedation with either MF or DF combination, the latter may be a better alternative because of less consumption of opioid analgesics. ChiCTR.org identifier: ChiCTR-TRC-13003645. KEYWORDS: analgesia; dexmedetomidine; discectomy; laminotomy; midazolam; sedation 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

Diagnostico e intervención temprana en niños con factores de riesgo de daño cerebral método Katona

Estimado Ciberpediatra te invito al Seminario de Pediatría, Cirugía Pediátrica y Lactancia Materna. El día 27 Abril 2016 las 21hrs (Centro, México DF, Guadalajara y Lima Perú) a la Conferencia: “Diagnostico e intervención temprana en niños con factores de riesgo de daño cerebral método Katona” por el “Dr. Eduardo Arias Kanemoto”, Neurologo Pediatra de la Cd de Queretaro La sesión inicia puntualmente las 21 hrs.
Para entrar a la Sala de Conferencia:
1.- hacer click en la siguiente liga, o cópiala y escríbela en tu buscador 

http://connectpro60196372.adobeconnect.com/cerebral_riesgo/

2.- “Entra como Invitado” Escribes tu nombre y apellido en el espacio en blanco
3.- Hacer click en el espacio que dice “Entrar en la Sala”
5.- A disfrutar la conferencia 

 6.- Recomendamos que dejes tu Nombre Completo, Correo electrónico y que participes.


Henrys


Dr. Enrique Mendoza López Webmaster: CONAPEME Coordinador Nacional: Seminario Ciberpeds-Conapeme Av La clinica 2520-310 Colonia Sertoma ,Mty N.L. México CP 64710 Tel-Fax 52 81 83482940 y 52 81 81146053 Celular 8183094806 www.conapeme.org www.pediatramendoza.com enrique@pediatramendoza.com emendozal@yahoo.com.mx

Libros de farmacología y dolor / Books on pharmacology and pain

Abril 24, 2016. No. 2306

Modern pharmacology with clinical application Fifth edition Libro / Book Acute Pain Management: Scientific evidence Third edition 2010 Australian and New Zealand College of Anaesthetists and Faculty of Pain Medicine Libro / Book 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.  correo electrónico; kikinhedz@gmail.com

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