Hipotermia intraoperatoria / Inadvertent Intraoperative hypothermia

Julio 3, 2016. No. 2376

La incidencia de hipotermia intraoperatoria inadvertida y sus factores de riesgo en pacientes sometidos a anestesia general en Beijing: un estudio prospectivo regional. Incidence of Inadvertent Intraoperative Hypothermia and Its Risk Factors in Patients Undergoing General Anesthesia in Beijing: A Prospective Regional Survey. Yi J1, Xiang Z2, Deng X3, Fan T4, Fu R5, Geng W6, Guo R7, He N8, Li C9, Li L10, Li M11, Li T12, Tian M13, Wang G14, Wang L15, Wang T16, Wu A17, Wu D18,Xue X19, Xu M20, Yang X19, Yang Z21, Yuan J22, Zhao Q23, Zhou G24, Zuo M25, Pan S2, Zhan L2, Yao M2, Huang Y1. PLoS One. 2015 Sep 11;10(9):e0136136. doi: 10.1371/journal.pone.0136136. eCollection 2015. Abstract BACKGROUND/OBJECTIVE: Inadvertent intraoperative hypothermia (core temperature <360 C) is a recognized risk in surgery and has adverse consequences. However, no data about this complication in China are available. Our study aimed to determine the incidence of inadvertent intraoperative hypothermia and its associated risk factors in a sample of Chinese patients. METHODS: We conducted a regional cross-sectional survey in Beijing from August through December, 2013. Eight hundred thirty patients who underwent various operations under general anesthesia were randomly selected from 24 hospitals through a multistage probability sampling. Multivariate logistic regression analyses were applied to explore the risk factors of developing hypothermia. RESULTS: The overall incidence of intraoperative hypothermia was high, 39.9%. All patients were warmed passively with surgical sheets or cotton blankets, whereas only 10.7% of patients received active warming with space heaters or electric blankets. Pre-warmed intravenous fluid were administered to 16.9% of patients, and 34.6% of patients had irrigation of wounds with pre-warmed fluid. Active warming (OR = 0.46, 95% CI 0.26-0.81), overweight or obesity (OR = 0.39, 95% CI 0.28-0.56), high baseline core temperature before anesthesia (OR = 0.08, 95% CI 0.04-0.13), and high ambient temperature (OR = 0.89, 95% CI 0.79-0.98) were significant protective factors for hypothermia. In contrast, major-plus operations (OR = 2.00, 95% CI 1.32-3.04), duration of anesthesia (1-2 h) (OR = 3.23, 95% CI 2.19-4.78) and >2 h (OR = 3.44, 95% CI 1.90-6.22,), and intravenous un-warmed fluid (OR = 2.45, 95% CI 1.45-4.12) significantly increased the risk of hypothermia. CONCLUSIONS: The incidence of inadvertent intraoperative hypothermia in Beijing is high, and the rate of active warming of patients during operation is low. Concern for the development of intraoperative hypothermia should be especially high in patients undergoing major operations, requiring long periods of anesthesia, and receiving un-warmed intravenous fluids. PDF Comité Europeo de Enseñanza en Anestesiología Curso de Actualización en Anestesiología Anestesia por Especialidades y Simposio Anestesia y Cirugía Plástica Seguras Agosto 5-7, 2016. Tijuana BC, México Información Dr. Sergio Granados Tinajero granadosts@gmail.com  16th World Congress of Anaesthesiologists 28 August - 2 September 2016  Hong Kong Convention and Exhibition Centre World Federation of Societies of Anaesthesiologists http://wca2016.com/

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

Cuidados paliativos / Paliative care

Junio 29, 2016. No. 2372

Tendencias de sedación continua hasta la muerte entre 2007 y 2013. Trends in Continuous Deep Sedation until Death between 2007 and 2013: A Repeated Nationwide Survey. Robijn L1,2, Cohen J1, Rietjens J1, Deliens L1,2, Chambaere K1,2. PLoS One. 2016 Jun 23;11(6):e0158188. doi: 10.1371/journal.pone.0158188. eCollection 2016. Abstract BACKGROUND: Continuous deep sedation until death is a highly debated medical practice, particularly regarding its potential to hasten death and its proper use in end-of-life care. A thorough analysis of important trends in this practice is needed to identify potentially problematic developments. This study aims to examine trends in the prevalence and practice characteristics of continuous deep sedation until death in Flanders, Belgium between 2007 and 2013, and to study variation on physicians' degree of palliative training. METHODS: Population-based death certificate study in 2007 and 2013 in Flanders, Belgium. Reporting physicians received questionnaires about medical practices preceding the patient's death. Patient characteristics, clinical characteristics (drugs used, duration, artificial nutrition/hydration, intention and consent), and palliative care training of attending physician were recorded. We posed the following question regarding continuous deep sedation: 'Was the patient continuously and deeply sedated or kept in a coma until death by the use of one or more drugs'. RESULTS: After the initial rise of continuous deep sedation to 14.5% in 2007 (95%CI 13.1%-15.9%), its use decreased to 12.0% in 2013 (95%CI 10.9%-13.2%). Compared with 2007, in 2013 opioids were less often used as sole drug and the decision to use continuous deep sedation was more often preceded by patient request. Compared to non-experts, palliative care experts more often used benzodiazepines and less often opioids, withheld artificial nutrition/hydration more often and performed sedation more often after a request from or with the consent of the patient or family. CONCLUSION: Worldwide, this study is the first to show a decrease in the prevalence of continuous deep sedation. Despite positive changes in performance and decision-making towards more compliance with due care requirements, there is still room for improvement in the use of recommended drugs and in the involvement of patients and relatives in the decision-making process. PDF Dolor y medicina paliativa Integrated pain and palliative medicine model. Bhatnagar S1, Gupta M2. Ann Palliat Med. 2016 May 24. pii: apm.2016.05.02. doi: 10.21037/apm.2016.05.02. [Epub ahead of print] Abstract Pain is one of the most common, distressing and feared symptom among cancer and other patients in need of palliative care. An estimated 25% of cancer patients and 25 million people die in pain each year. Effective pain and symptom management are the core elements of palliative carewhich aims at reducing suffering and improving quality of life (QOL) throughout the course of illness starting from diagnosis, in sync with curative treatments and at end of life. There is a prevailing shortage of manpower apt to deal with pain and providing cost-effective palliative care and with the rise of cancer, other chronic diseases and explosion of new life-prolonging therapeutic modalities, this 'Patient-pain and palliative physician' discrepancy is only going to increase, more so in developing countries. The need of the hour is to train all healthcare physicians and nurses especially those working in the field of chronic pain in principles of effective pain and symptom palliation, to integrate cancer pain and symptom management into existing pain management fellowships and to introduce a holistic pain and palliative care model at all levels of healthcare system. Simultaneously, of equal importance is to conduct research, evidence building and formulate policies and guidelines for meticulous symptom management among the diverse category of patients and diseases so as to have a personalized and individualistic approach to patient management. In this comprehensive review, we have pondered upon the need, advantages, barriers and recommendations to achieve ideal 'Integrated pain and palliative medicine' services, their equitable implementation and delivery to 'whomsoever in need of them'. PDF Comité Europeo de Enseñanza en Anestesiología Curso de Actualización en Anestesiología Anestesia por Especialidades y Simposio Anestesia y Cirugía Plástica Seguras Agosto 5-7, 2016. Tijuana BC, México Información Dr. Sergio Granados Tinajero granadosts@gmail.com  16th World Congress of Anaesthesiologists 28 August - 2 September 2016  Hong Kong Convention and Exhibition Centre World Federation of Societies of Anaesthesiologists http://wca2016.com/

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

Bibliotecas. Noticias

bibliotecas
Notificaciones diarias ⋅ 26 de junio de 2016
NOTICIAS


Milenio.com
Presentando FOLIO - Una nueva colaboración que reúne a bibliotecas, proveedores de servicios y ...
PR Newswire (Comunicado de prensa)
BOSTON, 25 de junio de 2016 /PRNewswire/ -- Las bibliotecas y los proveedores de servicios se han unido para transformar el futuro de las ...
Shirley Zuluaga, nueva directora de la Biblioteca Pública Piloto - El Colombiano
Cobertura total de la noticia




Critica
Organiza el IMCA programa “Mis vacaciones en la biblioteca”
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Europa Press
Santander.- Aprobado el expediente para contratar el nuevo programa de animación a la lectura ...
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Su objetivo es desarrollar algunas de las líneas estratégicas del Plan de Dinamización de lasBibliotecas Municipales aprobado en 2015, ...



EntornoInteligente
Ana Gonzalo Morales // BNP planteará la creación del Instituto Tecnológico para bibliotecarios
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Por noveno año consecutivo el “Desafío Leer” recorre las escuelas de Río Gallegos
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Diario de Los Andes
Biblioteca de Autores Tachirenses conmemorarán natalicio de Ramón J. Velásquez
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La Prensa (Nicaragua)
Las 10 curiosidades de los libros
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Biblioteca. La biblioteca más grande del mundo es la del Congreso de Estados Unidos, fundada en 1800 en Washington; tiene 138 millones de ...




Diario de Cádiz
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Diario de Cádiz
Debido al importante y numeroso fondo bibliográfico del instituto, y a la puesta en marcha previa de una biblioteca libre en la cafetería, pensó que ...


Concluyen 90 alumnos talleres de Japonés y Exprés Arte –Cómics
e-consulta Veracruz
Raúl Domínguez Martínez, coordinador de Bibliotecas Municipales, indicó que la ciudadanía respondió favorablemente a la invitación por parte del ...