Ondansetron

Estudio comparativo de ondansetron y dosis subhipnóticas de propofol en el control y tratamiento del prurito inducido por sufentanil intratecal en cesárea electiva The comparative study of intravenous Ondansetron and sub-hypnotic Propofol dose in control and treatment of intrathecal Sufentanil-induced pruritus in elective caesarean surgery. Hirmanpour A, Safavi M, Honarmand A, Hosseini AZ, Sepehrian M. J Res Pharm Pract. 2015 Apr-Jun;4(2):57-63. doi: 10.4103/2279-042X.155751. Abstract OBJECTIVE: Pruritus is a common and disturbing side effect of neuraxial opioids after cesarean section. The purpose of this study was to compare the efficacy of intravenous ondansetron and sub-hypnotic dose of propofol in control and treatment of intrathecal sufentanil induced pruritus in cesarean surgery. METHODS: Totally, 90 parturient with American Society of Anesthesiology physical status grade I-II, undergoing spinal anesthesia with 2.5 μg sufentanil and 10 mg bupivacaine 0.5% were enrolled to this randomized, prospective, double-blind study. The women were randomly assigned to two groups who received 8 mg ondansetron or 10 mg propofol to treat pruritus grade ≥3. The patient was evaluated after 5 min and in the lack of successful treatment, the doses of two drugs repeated and if the pruritus is on-going, the exact treatment with naloxone was done. FINDINGS: The incidence of pruritus was 69.3%. Both groups were well-matched. The peak time pruritus was 30-75 min after injection. The percentage of individuals consumed naloxone were 6.8% and 15.9% in ondansetron and propofol groups, respectively (P = 0.18). The mean score of satisfaction (according to visual analog scale criteria) was 9.09 ± 1.1 in ondansetron group and 9.3 ± 1.07 in the propofol group (P = 0.39). CONCLUSION: Ondansetrone and sub-hypnotic dose of propofol are both safe and well-tolerated. Due to their same efficacy in the treatment of intrathecal sufentanil-induced pruritus, they can be widely used in clinical practice. KEYWORDS: Caesarean surgery; Ondansetron; Propofol; intrathecal opioid; pruritus PDF   Administración profiláctica de ondansetron en la prevención de prurito y nausea y vomito inducidos por morfina intratecal en pacientes con cesárea. Prophylactic administration of ondansetron in prevention of intrathecal morphine-induced pruritus and post-operative nausea and vomiting in patients undergoing caesarean section. Koju RB, Gurung BS, Dongol Y. BMC Anesthesiol. 2015 Feb 17;15:18. doi: 10.1186/1471-2253-15-18. Abstract BACKGROUND: Intrathecal morphine is commonly used for post caesarean analgesia. However, their use is frequently associated with the incidence of troublesome side effects such as nausea, vomiting and pruritus. Various mechanisms have been postulated for the opioid-inducedpruritus, with a variety of medications with different mechanisms of actions formulated for the prevention and treatment. But, the results are inconsistent and hence the prevention and treatment of opioid-induced pruritus still remains a challenge. Ondansetron which is antiemetic, non-sedative and has no antianalgesic effect is an antagonist to 5-HT3 receptor, the receptor with which opioids interacts and imparts its effects.Ondansetron, thus, would be an attractive treatment strategy for both opioid-induced pruritus and post-operative nausea and vomiting. METHODS: After the approval from institutional review committee and written consent received from the patient, 50 healthy parturients of ASA I and II physical status undergoing caesarean section under spinal anaesthesia were enrolled for the study. They were randomly categorized into placebo group (2 ml normal saline) and treatment group (2 ml of 4 mg ondansetron), each group containing 25 patients. Pruritus and post-operative nausea and vomiting scores were recorded up to 24 hours after the administration of intrathecal morphine. Statistical analysis was performed using chi-square test. RESULTS: The incidence, severity and necessity of treatment for pruritus in the treatment group was significantly reduced compared to the placebo group (16% vs 88%). Similarly, the risk of post-operative nausea and vomiting in the treatment group was less compared to the placebo group (8% vs 56%). CONCLUSION: Prophylactic administration of ondansetron to parturients receiving intrathecal morphine for post-operative analgesia provides a significant reduction of intrathecal morphine-induced pruritus and nausea and vomiting. PDF

Atentamente Anestesia y Medicina del Dolor anestesia-dolor.org

Recordarán a Rafael Bernal con curso sobre novela criminal y ciclo de cine en el CC Elena Garro

Fuente
Este artículo es originalmente publicado en:

http://www.orgullosocitadino.com/2015/06/recordaran-rafael-bernal-con-curso.html

Un Orgulloso Citadino

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Recordarán a Rafael Bernal con curso sobre novela criminal y ciclo de cine en el CC Elena Garro Posted: 22 Jun 2015 04:59 PM PDT El Centro Cultural Elena Garro brinda un homenaje al escritor Rafael Bernal, a cien años de su nacimiento, con la programación de dos actividades que tienen como marco el llamado género negro, cultivado con éxito en varias de las obras de Bernal. El pretexto perfecto será la más memorable de las novelas policiacas hechas en este país: El complot mongol, libro de culto entre los amantes de este género, y obra con la que Bernal alcanzara la inmortalidad en las letras mexicanas. Inician los festejos con la programación del curso México Negro: panorama de la novela criminal contemporánea en México, impartido por el también escritor Eduardo Antonio Parra, quien realizará un repaso sobre las características del género negro, desde su aparición en la literatura anglosajona, su devenir a través de los años, los modelos extranjeros que han influido en los escritores mexicanos para adaptarlos a nuestra cultura y a nuestro país, y subrayará su evolución en la literatura mexicana. A partir de la segunda sesión hasta el final del curso se comentarán las obras que fueron conformando la novela criminal en México: partiremos Ensayo de un crimen, de Rodolfo Usigli. El complot mongol, de Rafael Bernal, que será la pieza angular del curso, para seguir con Dos crímenes, de Jorge Ibargüengoitia, Cosa fácil, de Paco Ignacio Taibo II, Luna de escarlata, de Rolo Díez, Linda 67, de Fernando del Paso, El miedo a los animales, de Enrique Serna y Balas de plata, de Élmer Mendoza. Mediante la charla con los participantes se identificará el valor literario de estas obras, y el tipo de sociedad y de país que cada uno de los autores plasmó en sus páginas como telón de fondo de sus historias. México Negro: panorama de la novela criminal contemporánea en México inicia el próximo martes, 23 de junio, en un horario de 12 a 14 horas. La segunda invitación responde a una muestra del género negro llevada a la pantalla grande, como parte de los ciclos de Cineclub, que se realizan todos los lunes a las 18:30 horas en el Centro Cultural. El ciclo es Cine negro, y tomará, nuevamente como pretexto para hablar de Bernal, su novela El complot mongol, adaptada al cine en 1977 por Antonio Eceiza. A pesar de no ser una producción de gran factura, la proyección servirá para charlar del escritor, de la obra original y de lo que se queda y lo que se va al realizar esta adaptación. En ese marco, se contemplan algunas películas que conformarán el ciclo Cine negro. Entre los nombres que están por confirmar se encuentran El Halcón Maltés de John Huston, de 1941, La sombra de una duda, de Alfred Hitchcock, 1943,  Ensayo de un crimen, de Luis Buñuel, 1955, Cadena perpetua, de Arturo Ripstein, 1979 y Terciopelo Azul, de David Lynch, 1986. Todas las películas, como cada  lunes de Cineclub serán presentadas y comentadas por gente de cine o literatura, especialistas en el tema. La cita es a las 18:30 horas, los lunes del mes de agosto en el Centro Cultural Elena Garro. La entrada es libre. Sobre los autores Rafael Bernal nació en la Ciudad de México el 28 de junio de 1915. Sus primeras obras publicadas datan de 1941, pero fue hasta 1969 cuando alcanza un mayor reconocimiento en las letras mexicanas con la publicación de El complot mongol, Pero la creación literaria de Rafael Bernal fue más que un solo libro. Hizo dramaturgia, cuentos, y programas para radio y televisión. Algunas de sus obras en la línea policiaca son las novelas Su nombre era muerte, Tres novelas policíacas, Un muerto en su tumba. Publicó algunas obras de teatro como Antonia, El maíz en la casa y La paz contigo, de corte histórico y social, y su único libro de versos Improperio a Nueva York y otros poemas. Bernal fue además un viajero incansable, gracias a su participación en la diplomacia mexicana. Estudió en el Colegio Francés de San Borja y en el Instituto de Ciencias y Letras de Ciudad de México; el bachillerato lo hizo en el Loyola College de Montreal, Canadá. Después de recibir el doctorado en literatura en la Universidad de Friburgo, Suiza,  en 1972, murió a la edad de 57 años. Eduardo Antonio Parra es narrador y ensayista, autor de cuentos y novelas enmarcadas en la corriente narrativa denominada Literatura del Norte. Entre su obra publicada se encuentran los libros de cuentos Los límites de la noche, Tierra de nadie, Parábolas del silencio; las novelas Nostalgia de la sombra y Juárez. El rostro de piedra. Ha sido merecedor de diferentes premios como el Internacional de Cuento Juan Rulfo 2000, El Premio Nacional de cuento Efrén Hernández 2004 y Premio Antonin Artaud 2010, entre otros galardones. El Centro Cultural Elena Garro está ubicado en el número 43 de la calle Fernández Leal, en el Barrio de la Concepción, Coyoacán, México, D. F.

Opioides i.v. / I.V. opioids

Revisión clínica de opioides intravenosos en cuidado agudo Clinical review of intravenous opioids in acute care Mark J. McKeen and Sadeq A. Quraishi Journal of Anesthesiology and Clinical Science 2013, Abstract Opioids are routinely used in the management of moderate to severe pain. However, in the acute care setting, consistently undertreated and suboptimally managed pain continues to be a problem. Given the potential for opioids to result in lifethreatening situations, and the increasing complexity of the patients that are cared for in acute care facilities, a thorough understanding of intravenous opioid therapy is a necessity for hospital-based clinicians. Opioids can be classified by chemical structure and/or drug effect (i.e. action on Mu, Kappa, and Delta opioid receptors throughout the body). Endogenous opioids include endorphins, enkephalins, and dynorphins, which moderate the body's natural response to pain. Commonly used exogenous intravenous opioids include morphine, hydromorphone, fentanyl, meperidine, methadone, buprenorphine, butorphanol, and nalbuphine, which vary greatly in potency, duration of action, metabolism, and in their adverse effect profile. A growing body of evidence suggests that patient controlled analgesia may be superior to conventional methods (need for analgesia determined by clinicians) of treating pain in the acute care setting. Newer pump delivery systems may also decrease the risks of human and equipment errors as well as enhance patient safety and satisfaction. The purpose of this review is to help guide clinicians in the safe and effective management of pain in patients requiring intravenous opioid therapy in the acute care setting. Keywords: Acute pain, acute care, opioid, PCA PDF Impacto de la edad, sexo y ruta de administración sobre los eventos adversos de los opioides en el departamento de emergencias. Estudio retrospectivo Impact of age, sex and route of administration on adverse events after opioid treatment in the emergency department: a retrospective study. Daoust R, Paquet J, Lavigne G, Piette É, Chauny JM. Pain Res Manag. 2015 Jan-Feb;20(1):23-8. PDF Estudio clínico aleatorizado de un protocolo con hidromorfona intravenosa versus el cuidado habitual en el dolor agudo de los ancianos en el departamento de urgencias. Randomized clinical trial of an intravenous hydromorphone titration protocol versus usual care for management of acute pain in older emergency department patients. Chang AK, Bijur PE, Davitt M, Gallagher EJ. Drugs Aging. 2013 Sep;30(9):747-54. doi: 10.1007/s40266-013-0103-y. Abstract BACKGROUND AND OBJECTIVES: Opioid titration is an effective strategy for treating pain; however, titration is generally impractical in the busy emergency department (ED) setting. Our objective was to test a rapid, two-step, hydromorphone titration protocol against usual care in older patients presenting to the ED with acute severe pain. METHODS: This was a prospective, randomized clinical trial of patients 65 years of age and older presenting to an adult, urban, academic ED withacute severe pain. The study was registered at http://www.clinicaltrials.gov (NCT01429285). Patients randomized to the hydromorphone titration protocol initially received 0.5 mg intravenous hydromorphone. Patients randomized to usual care received any dose of any intravenous opioid. At 15 min, patients in both groups were asked, 'Do you want more pain medication?' Patients in the hydromorphone titration group who answered 'yes' received a second dose of 0.5 mg intravenous hydromorphone. Patients in the usual care group who answered 'yes' had their ED attending physician notified, who then could administer any (or no) additional medication. The primary efficacy outcome was satisfactory analgesia defined a priori as the patient declining additional analgesia at least once when asked at 15 or 60 min after administration of the initial opioid. Dose was calculated in morphine equivalent units (MEU: 1 mg hydromorphone = 7 mg morphine). The need for naloxone to reverse adverse opioid effects was the primary safety outcome. RESULTS: 83.0 % of 153 patients in the hydromorphone titration group achieved satisfactory analgesia compared with 82.5 % of 166 patients in the usual care group (p = 0.91). Patients in the hydromorphone titration group received lower mean initial doses of opioids at baseline than patients in the usual care group (3.5 MEU vs. 4.7 MEU, respectively; p ≤ 0.001) and lower total opioids through 60 min (5.3 MEU vs. 6.0 MEU; p = 0.03). No patient needed naloxone. CONCLUSIONS: Low-dose titration of intravenous hydromorphone in increments of 0.5 mg provides comparable analgesia to usual care with lessopioid over 60 min. PDF Comparación de nalbufina con morfina en sus efectos analgésicos y seguridad. Meta-análisis de estudios aleatorizados controlados A comparision of nalbuphine with morphine for analgesic effects and safety : meta-analysis of randomized controlled trials. Zeng Z, Lu J, Shu C, Chen Y, Guo T, Wu QP, Yao SL, Yin P. Sci Rep. 2015 Jun 3;5:10927. doi: 10.1038/srep10927. PDF

Atentamente Anestesia y Medicina del Dolor anestesia-dolor.org

Las personas que comen chocolate tienen el corazón más sano

Fuente
Este artículo es originalmente publicado en:
http://www.madrimasd.org/informacionidi/noticias/noticia.asp?id=63923&origen=notiweb&dia_suplemento=martes

Un estudio observa una relación entre el mayor consumo de chocolate y un menor riesgo de sufrir enfermedades cardiovasculares.

FUENTE | El País Digital

Los espacios verdes influyen en el desarrollo cognitivo de los niños

Fuente
Este artículo es originalmente publicado en:
http://www.madrimasd.org/informacionidi/noticias/noticia.asp?id=63921&origen=notiweb&dia_suplemento=martes

Los espacios verdes influyen en el desarrollo cognitivo de los niños, según concluye un estudio con 2.600 alumnos de primaria desarrollado por un equipo científico con participación del Consejo Superior de Investigaciones Científicas(CSIC).

FUENTE | CSIC

Más de bloqueo del plexo braquial/More on brachial plexus block

Comparación de técnicas de bloqueo del plexo braquial axilar guiadas por ultrasonido: inyección perineural contra la infiltración perivascular simple o doble. Comparison of ultrasound-guided axillary brachial plexus block techniques: perineural injection versus single or double perivascular infiltration. Cho S, Kim YJ, Baik HJ, Kim JH, Woo JH. Yonsei Med J. 2015 May;56(3):838-44. doi: 10.3349/ymj.2015.56.3.838. Abstract PURPOSE: We compared three methods of ultrasound-guided axillary brachial plexus block, which were single, and double perivascular (PV) infiltration techniques, and a perineural (PN) injection technique. MATERIALS AND METHODS: 78 patients of American Society of Anesthesiologists physical status I-II undergoing surgery of the forearm, wrist, or hand were randomly allocated to three groups. 2% lidocaine with epinephrine 5 μg/mL was used. The PN group (n=26) received injections at the median, ulnar, and radial nerve with 8 mL for each nerve. The PV1 group (n=26) received a single injection of 24 mL at 12-o'clock position of the axillary artery. The PV2 group (n=26) received two injections of 12 mL each at 12-o'clock and 6-o'clock position. For all groups, musculocutaneous nerve was blocked separately. RESULTS: The PN group (391.2±171.6 sec) had the longest anesthetic procedure duration than PV1 (192.8±59.0 sec) and PV2 (211.4±58.6 sec). There were no differences in onset time. The average induction time was longer in PN group (673.4±149.6 sec) than PV1 (557.6±194.9 sec) and PV2 (561.5±129.8 sec). There were no differences in the success rate (89.7% vs. 86.2% vs. 89.7%). CONCLUSION: The PV injection technique consisting of a single injection in 12-o'clock position above the axillary artery in addition to a musculocutaneous nerve block is equally effective and less time consuming than the PN technique. Therefore, the PV technique is an alternative method that may be used in busy clinics or for difficult cases. KEYWORDS: Brachial plexus; nerve block; ultrasonography PDF Dexmedetomidina como adyuvante de ropivacaína en el bloqueo supraclavicular del plexo braquial Dexmedetomidine as an adjuvant to ropivacaine in supraclavicular brachial plexus block. Kathuria S, Gupta S, Dhawan I. Saudi J Anaesth. 2015 Apr-Jun;9(2):148-54. doi: 10.4103/1658-354X.152841. Abstract CONTEXT: Dexmedetomidine as an adjuvant to local anesthetics in peripheral nerve blocks has been used in only a few studies. AIMS: We aimed at assessing the effect of dexmedetomidine as an adjuvant to ropivacaine in supraclavicular brachial plexus block. SETTINGS AND DESIGN: Random, controlled, and triple blind. MATERIALS AND METHODS: Sixty American Society of Anesthesiologist grade I and II patients of either sex scheduled for elective upper limb surgery under supraclavicular brachial plexus block were divided into three equal groups in a prospective randomized double-blind controlled manner. For block patients in Group C received 0.5% ropivacaine (30cc), 0.5% ropivacaine with 50 μg dexmedetomidine (30cc) in Group D and 0.5% ropivacaine (30cc) in Group D-IV along with intravenous infusion of 50 μg dexmedetomidine in normal saline. STATISTICAL ANALYSIS USED: IBM-SPSS software version 17, Chi-square test, Mann-Whitney U-test. RESULTS: Demographic profile and surgical characteristics were similar in all the three groups. Sensory block and motor block onset was earlier in group D than in group D-IV and group C. The sensory block and motor block duration was also prolonged in group D when compared with group D-IV and group C. The duration of analgesia was significantly longer in group D and D-IV when compared to group C. CONCLUSIONS: Dexmedetomidine as an adjuvant to 0.5%ropivacaine in ultrasound guided brachial plexus block shortens the sensory as well as motor block onset time, prolongs sensory and motor block duration and also increases the duration of analgesia. The action of dexmedetomidine most probably is local rather than centrally mediated. KEYWORDS: Dexmedetomidine; ropivacaine; supraclavicular brachial plexus block PDF

Atentamente Anestesia y Medicina del Dolor anestesia-dolor.org

Hace 2000 días/Two thousand days ago

Hace 2000 días, el primero de Enero 2010, iniciamos este Programa Educativo Alfa como un proyecto dedicado a enviar cada día artículos en PDF o en HTML a un reducido grupo de colegas anestesiólogos, intensivistas, cirujanos, internistas, algólogos y especialidades relacionadas, incluyendo enfermeras y estudiantes de medicina. El proyecto inicial se ha convertido en un programa educativo exitoso que llega a 4500 miembros en los cinco continentes, muy en especial a los países de Latinoamérica. Se han enviado 7,540 artículos, 45 libros, varias revistas completas, y videoclips. Además se han promovido cursos, eventos, congresos y enlaces de interés académico. Al principio teníamos dudas sobre su utilidad, pero al paso de los primeros meses vimos con agrado la buena aceptación y crecimiento lento y paulatino del número de subscritores, con un bajo porcentaje de cancelaciones. Hoy en día no solo se envían artículos completos, sino que hemos agregado enlaces a revistas, a libros, videos y recién creamos el correo con la Imagen del Mes, donde se incluyen fotografías clínicas originales adicionadas de información médica disponible en la WEB. Al paso de estos 2000 días hemos aprendido a seleccionar la información enviada, a escuchar las sugerencias recibidas, a responder las consultas de colegas y pacientes con prontitud, al igual que hemos ido presentando y publicando nuestra propia experiencia en diversos foros y revistas biomédicas. La meta fundamental de nuestro portal www.anestesia-dolor.org es facilitar la educación médica continuada utilizando la información gratuita y selecta disponible en la WEB. Agradecemos el dejarnos llegar con este programa hasta su ordenador, y se le invita a seguir con nosotros, y a difundir este programa educativo entre sus colegas. Si desea hacer un donativo económico que nos ayude a mejorar este programa le estaremos muy agradecidos. Aprovechamos la coincidencia de fechas para FELICITAR a todos los colegas que además de llevar en hombros su responsabilidad profesional, hoy celebran el DIA de los PADRES!   2000 days ago, January first 2010, we initiated this Educational Alfa Program as a project dedicated to daily post articles in PDF or HTML to a small group of colleagues anesthesiologists, intensivists, surgeons, internists, pain medicine, and related specialties, including nurses and medical students. The initial project has become a successful educational program that reaches 4,500 members on five continents, most in Latin America countries. We have sent 7,540 articles, 45 books, several full magazines, and video clips. We have also promoted courses, events, conferences and links with academic interest. We initially had doubts about its usefulness, but over the first few months we saw with pleasure the good acceptance and slow and gradual growth in the number of subscribers, with a very low percentage of cancellations. Besides all this, we've added links to journals, books, videos and newly created the Image of the Month, where original clinical photographs and medical information are included. In these 2000 days we have learned to select the information to be sent, listen to suggestions received, and answer queries from colleagues and patients promptly. We also have been presenting and publishing our own experience in various forums and biomedical journals. The primary goal of our website www.anestesia-dolor.org is to facilitate continuing medical education using select information available free on the Web. We appreciate letting us get this program to your computer, invite you to follow us, and ask you to spread this education program among your colleagues. If you want to make a financial donation to help us to improve this program we would be very grateful. We take this coincidence of dates to congratulate all colleagues that in addition to carrying on their shoulders their professional responsibility, today celebrate Father's Day!  Academic Medicine, Vol. 90, No. 6 / June 2015 Revista/Journal  American Journal of the Medical Sciences: April 2015 - Volume 349 - Issue 4 Revista/Journal  Journal of Clinical Anesthesia 2015  Volume 27, Issue 1, p1-96 Revista/Journal Saudi J Anaesth 2015 July-September. Volume 9, Issue 3 Revista/Journal Anesthesia & Analgesia  June 2014 - Volume 118 - Issue 6 Revista/Journal   Annals of Surgery  May 2015 - Volume 261 - Issue 5 Revista/Journal   Journal of Anesthesia & Critical Care: Open Access 2015:3(2) Revista/Journal  AACN Advanced Critical Care April/June 2011 - Volume 22 - Issue 2 Revista/Journal   British Journal of Pain May 2015 Issue on Cancer Pain Revista/Journal  Topics in Public Health Edited by David Claborn, ISBN 978-953-51-2132-9, 306 pages, Publisher: InTech Libro/Book Autoimmunity - Pathogenesis, Clinical Aspects and Therapy of Specific Autoimmune Diseases Edited by Katerina Chatzidionysiou, ISBN 978-953-51-2134-3, 208 pages, Publisher: InTech Libro/Book

Atentamente Anestesia y Medicina del Dolor anestesia-dolor.org

Bibliotecarios.Alerta

Bibliotecarios

NOTICIAS


Peninsular Digital

Capacita el INEGI a bibliotecarios de la UABCS
Peninsular Digital
Con el objetivo de capacitar al personal de atención del Centro de Desarrollo Bibliotecario de la UABCS en el uso del Mapa Digital de México, ...




regionalpuebla.mx

Capacitarán a 36 bibliotecarios para cursos de verano
regionalpuebla.mx
La coordinadora regional de bibliotecarios Lourdes López, informó que son 36 personas de 18 municipios los que acudirán a recibir esta orientación ...




Misiones Cuatro

Capacitan en Encuadernación a docentes y bibliotecarios
Misiones Cuatro
El Taller de Encuadernación bajo parámetros de conservación es una nueva capacitación organizada por la Biblioteca Pública De Las Misiones que ...




Centro Arte

Celebran Día del Bibliotecario en Sagua la Grande
Centro Arte
Coincidiendo con el cierre de la VI Jornada por el Día del Bibliotecario cubano que se ha estado celebrando a lo largo y ancho del país desde el 8 ...



Ministerio de Cultura entregará tecnología a bibliotecas públicas
El Informador - Santa Marta
Los bibliotecarios deben recibir la dotación tecnológica, y gestionar, posteriormente, la firma del acta de entrega de la tecnología por parte del ...

Consideraciones de Oxigenacion en Pediatría

Estimado Pediatra te invito al Seminario de Pediatría, Cirugía Pediátrica y Lactancia Materna. El día 24 de Junio 2015 las 21hrs (Centro, México DF, Guadalajara y Lima Perú) a la Conferencia: “Consideraciones de Oxigenacion en Pediatría” por el “Dr. Jesús Guajardo”, Alergologo, Neumologo Pediatra de la Cd. de San Antonio Tx. 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/oxigenacion_pediatrica/
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

Falla respiratoria postoperatoria/Postoperative respiratory failure

Desarrollo y validación de una puntuación para predecir falla respiratoria aguda postoperatoria en una cohorte multicéntrica Europea. Estudio prospectivo, observacional Development and validation of a score to predict postoperative respiratory failure in a multicentre European cohort: A prospective, observational study. Canet J, Sabaté S, Mazo V, Gallart L, de Abreu MG, Belda J, Langeron O, Hoeft A, Pelosi P; PERISCOPE group. European Journal of Anaesthesiology July 2015 - Volume 32 - Issue 7 - p 458-470 PDF Eliminar las complicaciones respiratorias postoperatorias: la detección preoperatoria abre la puerta a las vías clínicas que individualizan el tratamiento perioperatorio Eliminate postoperative respiratory complications: preoperative screening opens the door to clinical pathways that individualise perioperative treatment Staehr-Rye, Anne K.; Eikermann, Matthias European Journal of Anaesthesiology: July 2015 - Volume 32 - Issue 7 - p 455-457 Pulmonary complications, including postoperative respiratory failure, represent the second most frequent form of postoperative complications after surgical site infections, with an incidence estimated to range from 2.0 to 7.9%, depending on the definitions and patients studied.1 Postoperative respiratory failure is a severe complication, which leads to a longer hospital stay, higher financial cost and increases the in-hospital death rate by as much as 90-fold.2,3 PDF Validación externa prospectiva de una puntuación predictiva de complicaciones pulmonares postoperatorias. Prospective external validation of a predictive score for postoperative pulmonary complications. Mazo V, Sabaté S, Canet J, Gallart L, de Abreu MG, Belda J, Langeron O, Hoeft A, Pelosi P. Anesthesiology. 2014 Aug;121(2):219-31. doi: 10.1097/ALN.0000000000000334. Abstract BACKGROUND: No externally validated risk score for postoperative pulmonary complications (PPCs) is currently available. The authors tested the generalizability of the Assess Respiratory Risk in Surgical Patients in Catalonia risk score for PPCs in a large European cohort (ProspectiveEvaluation of a RIsk Score for postoperative pulmonary COmPlications in Europe). METHODS: Sixty-three centers recruited 5,859 surgical patients receiving general, neuraxial, or plexus block anesthesia. The Assess RespiratoryRisk in Surgical Patients in Catalonia factors (age, preoperative arterial oxygen saturation in air, acute respiratory infection during the previous month, preoperative anemia, upper abdominal or intrathoracic surgery, surgical duration, and emergency surgery) were recorded, along with PPC occurrence (respiratory infection or failure, bronchospasm, atelectasis, pleural effusion, pneumothorax, or aspiration pneumonitis). Discrimination, calibration, and diagnostic accuracy measures of the Assess Respiratory Risk in Surgical Patients in Catalonia score's performance were calculated for the Prospective Evaluation of a RIsk Score for postoperative pulmonary COmPlications in Europe cohort and three subsamples: Spain, Western Europe, and Eastern Europe. RESULTS: The full Prospective Evaluation of a RIsk Score for postoperative pulmonary COmPlications in Europe data set included 5,099 patients; 725 PPCs were recorded for 404 patients (7.9%). The score's discrimination was good: c-statistic (95% CI), 0.80 (0.78 to 0.82). Predicted versus observed PPC rates for low, intermediate, and high risk were 0.87 and 3.39% (score <26), 7.82 and 12.98% (≥ 26 and <45), and 38.13 and 38.01% (≥ 45), respectively; the positive likelihood ratio for a score of 45 or greater was 7.12 (5.93 to 8.56). The score performed best in the Western Europe subsample-c-statistic, 0.87 (0.83 to 0.90) and positive likelihood ratio, 11.56 (8.63 to 15.47)-and worst in the Eastern Europe subsample. The predicted (5.5%) and observed (5.7%) PPC rates were most similar in the Spain subsample. CONCLUSIONS: The Assess Respiratory Risk in Surgical Patients in Catalonia score predicts three levels of PPC risk in hospitals outside thedevelopment setting. Performance differs between geographic areas. PDF Desarrollo y validación de una calculadora de riesgo para predecir la insuficiencia respiratoria postoperatoria. Development and validation of a risk calculator predicting postoperative respiratory failure. Gupta H1, Gupta PK, Fang X, Miller WJ, Cemaj S, Forse RA, Morrow LE. Chest. 2011 Nov;140(5):1207-15. doi: 10.1378/chest.11-0466. Epub 2011 Jul 14. Abstract BACKGROUND: Postoperative respiratory failure (PRF) (requiring mechanical ventilation > 48 h after surgery or unplanned intubation within 30 days of surgery) is associated with significant morbidity and mortality. The objective of this study was to identify preoperative factors associated with an increased risk of PRF and subsequently develop and validate a risk calculator. METHODS: The American College of Surgeons National Surgical Quality Improvement Program (NSQIP), a multicenter, prospective data set (2007-2008), was used. The 2007 data set (n = 211,410) served as the training set and the 2008 data set (n = 257,385) as the validation set. RESULTS: In the training set, 6,531 patients (3.1%) developed PRF. Patients who developed PRF had a significantly higher 30-day mortality (25.62% vs 0.98%, P < .0001). On multivariate logistic regression analysis, five preoperative predictors of PRF were identified: type of surgery, emergency case, dependent functional status, preoperative sepsis, and higher American Society of Anesthesiologists (ASA) class. The risk model based on the training data set was subsequently validated on the validation data set. The model performance was very similar between the training and the validation data sets (c-statistic, 0.894 and 0.897, respectively). The high c-statistics (area under the receiver operating characteristic curve) indicate excellent predictive performance. The risk model was used to develop an interactive risk calculator. CONCLUSIONS: Preoperative variables associated with increased risk of PRF include type of surgery, emergency case, dependent functional status, sepsis, and higher ASA class. The validated risk calculator provides a risk estimate of PRF and is anticipated to aid in surgical decision making and informed patient consent. PDF

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