Más de ketamina en asma / More on ketamine for asthma

Octubre 18, 2016. No. 2482

Ketamina intravenosa en broncoespasmo refractario recipitado por infección por H1N1 Intravenous Ketamine for Refractory Bronchospasm Precipitated by H1N1 Infection. Agrawal A1, Shrivastava J1. Front Pediatr. 2014 Apr 2;2:24. doi: 10.3389/fped.2014.00024. eCollection 2014. Abstract Acute severe bronchospasm is an emergency situation and sometimes these children may fail to respond to conventional treatment and deteriorate rapidly to respiratory failure requiring mechanical ventilation. We present a case of 2-year-old girl, who presented with severe bronchospasm resulting in respiratory failure not responding to conventional management including mechanical ventilation and was found to be H1N1 positive. She was treated with ketamine infusion, which led to prompt improvement in airway obstruction. KEYWORDS: H1N1 infection; acute severe asthma; bronchospasm; ketamine; wheezing PDF Ketamina en estado asmático. Revisión Ketamine in status asthmaticus: A review. Goyal S1, Agrawal A. Indian J Crit Care Med. 2013 May;17(3):154-61. doi: 10.4103/0972-5229.117048. Abstract BACKGROUND AND AIMS: Status asthmaticus is a common cause of morbidity and mortality. The addition of ketamine to the standard treatment regimen of severe asthma has shown to improve outcome and alleviate the need for mechanical ventilation. The purpose of this review is to determine the pulmonary effects of ketamine and to determine whether sufficient evidence exists to support its use for refractory status asthmaticus. DATA SOURCE: MEDLINE, EMBASE, Google Scholar, and Cochrane data bases (from their inception to Jan 2012) using key words "ketamine", "asthma", "bronchospasm", "bronchodilator", and "mechanical ventilation" were searched to identify the reports on the use of ketamine as a bronchodilator in acute severe asthma or status asthmaticus, and manual review of article bibliographies was done. Relevant databases were searched for the ongoing trials on use of ketamine as a bronchodilator. Outcome measures were analyzed using following clinical questions: Indication, dose and duration of ketamine use, main effects on respiratory mechanics, adverse effects, and mortality. RESULTS: Twenty reports illustrating the use of ketamine as a bronchodilator were identified. In total, 244 patients aged 5 months to 70 years received ketamine for bronchospasm. Twelve case reports, 3 double-blind randomized placebo-controlled trials, 2 prospective observational studies, 2 clinical evaluation study, and 1 retrospective chart review were retrieved. Most of the studies showed improved outcome with use of ketamine in acute severe asthma unresponsive to conventional treatment. Patients who received ketamine improved clinically, had lower oxygen requirements, and obviated the need for invasive ventilation. Mechanically-ventilated patients for severe bronchospasm showed reduction in peak inspiratory pressures, improved gas exchange, dynamic compliance and minute ventilation, and could be weaned off successfully following introduction of ketamine. CONCLUSION: In various studies, ketamine has been found to be a potential bronchodilator in severe asthma. However, a large prospective clinical trial is warranted before laying down any definitive recommendations on its use in status asthmaticus. KEYWORDS: Bronchodilator; emergency department; intensive care unit; ketamine; status asthmaticus PDF Exacerbación grave de asma aguda en niños: un enfoque progresivo para la escalada de la terapia en una unidad de cuidados intensivos pediátricos. Severe acute asthma exacerbation in children: a stepwise approach for escalating therapy in a pediatric intensive care unit. Nievas IF1, Anand KJ. J Pediatr Pharmacol Ther. 2013 Apr;18(2):88-104. doi: 10.5863/1551-6776-18.2.88. Abstract OBJECTIVES: An increasing prevalence of pediatric asthma has led to increasing burdens of critical illness in children with severeacute asthma exacerbations, often leading to respiratory distress, progressive hypoxia, and respiratory failure. We review the definitions, epidemiology, pathophysiology, and clinical manifestations of severe acute asthma, with a view to developing an evidence-based, stepwise approach for escalating therapy in these patients. METHODS: Subject headings related to asthma, status asthmaticus, critical asthma, and drug therapy were used in a MEDLINE search (1980-2012), supplemented by a manual search of personal files, references cited in the reviewed articles, and treatment algorithms developed within Le Bonheur Children's Hospital. RESULTS: Patients with asthma require continuous monitoring of their cardiorespiratory status via noninvasive or invasive devices, with serial clinical examinations, objective scoring of asthma severity (using an objective pediatric asthma score), and appropriate diagnostic tests. All patients are treated with β-agonists, ipratropium, and steroids (intravenous preferable over oral preparations). Patients with worsening clinical status should be progressively treated with continuous β-agonists, intravenous magnesium, helium-oxygen mixtures, intravenous terbutaline and/or aminophylline, coupled with high-flow oxygen and non-invasive ventilation to limit the work of breathing, hypoxemia, and possibly hypercarbia. Sedation with low-dose ketamine (with or without benzodiazepines) infusions may allow better toleration of non-invasive ventilation and may also prepare the patient for tracheal intubation and mechanical ventilation, if indicated by a worsening clinical status. CONCLUSIONS: Severe asthma can be a devastating illness in children, but most patients can be managed by using serial objective assessments and the stepwise clinical approach outlined herein. Following multidisciplinary education and training, this approach was successfully implemented in a tertiary-care, metropolitan children's hospital. KEYWORDS: asthma; child; critical care; infant; respiratory failure; status asthmaticus PDF La inhalación de ketamina disminuye el asma murina inducida por ovalbúmina al suprimir la transición epitelial mesenquimatosa Ketamine Inhalation Ameliorates Ovalbumin-Induced Murine Asthma by Suppressing the Epithelial-Mesenchymal Transition. Song L1, Sen S2, Sun Y3, Zhou J1, Mo L1, He Y2. Med Sci Monit. 2016 Jul 15;22:2471-83. Abstract BACKGROUND Asthma accounts for 0.4% of all deaths worldwide, a figure that increases annually. Ketamine induces bronchial smooth muscle relaxation, and increasing evidence suggests that its anti-inflammatory properties might protect against lung injury and ameliorate asthma. However, there is a lack of evidence of the usefulness and mechanism of ketamine in acute asthma exacerbation. This study aimed to analyze the therapeutic effects and mechanism of action of ketamine on acute ovalbumin (OVA)-induced murine asthma. MATERIAL AND METHODS In vivo, BALB/c mice with OVA-induced asthma were treated with or without ketamine (25 or 50 mg/mL). Serum, lung sections, and mononuclear cell suspensions from the lung were collected for histological, morphometric, immunofluorescence, microRNA, quantitative polymerase chain reaction, regulatory T cell identification, cytokine, and Western blotting analyses. In vitro, bronchial epithelial cells were cultured to analyze the effect and mechanism of ketamine on epithelial-mesenchymal transition (EMT) and transforming growth factor-β (TGF-β) signaling. RESULTS The inhalation of ketamine 25 or 50 mg/mL markedly suppressed OVA-induced airway hyper-responsiveness and airway inflammation, significantly increased the percentage of CD4+CD25+ T cells, and significantly decreased OVA-induced up-regulation of TGF-β1 and the EMT. MiR-106a was present at higher amounts in OVA-induced lung samples and was suppressed by ketamine treatment. The in vitro results showed that TGF-β1-induced EMT was suppressed by ketamine via miR-106a level regulation. CONCLUSIONS Ketamine ameliorates lung fibrosis in OVA-induced asthmatic mice by suppressing EMT and regulating miR-106a level, while ketamine inhalation might be a new therapeutic approach to the treatment of allergic asthma. PDF XIII Congreso Virtual Mexicano de Anestesiología Inscripciones abiertas Octubre a Diciembre 2016 Información / Information L Congreso Mexicano de Anestesiología Noviembre 2-6, 2016 Información / Information 17h World Congress of Anaesthesiologists, WFSA Sep 6-11, 2020 Prague, Czech Republic Informes / Information

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

Colapso materno

Octubre 19, 2016. No. 2483

Colapso materno: desafiando la regla de cuatro minutos Maternal collapse: Challenging the four-minute rule. Benson MD1, Padovano A2, Bourjeily G3, Zhou Y4. EBioMedicine. 2016 Apr;6:253-7. doi: 10.1016/j.ebiom.2016.02.042. Epub 2016 Mar 2. Abstract INTRODUCTION: The current approach to, cardiopulmonary resuscitation of pregnant women in the third trimester has been to adhere to the "four-minute rule": If pulses have not returned within 4min of the start of resuscitation, perform a cesarean birth so that birth occurs in the next minute. This investigation sought to re-examine the evidence for the four-minute rule. METHODS: A literature review focused on perimortem cesarean birth was performed using the same key words that were used in formulating the "four-minute rule." Maternal and neonatal injury free survival rates as a function of arrest to birth intervals were determined, as well as actual incision to birth intervals. RESULTS: Both maternal and neonatal injury free survival rates diminished steadily as the time interval from maternal arrest to birth increased. There was no evidence for any specific survival threshold at 4min. Skin incision to birth intervals of 1min occurred in only 10% of women. CONCLUSION: Once a decision to deliver is made, care providers should proceed directly to Cesarean birth during maternal cardiac arrest in the third trimester rather than waiting for 4min for restoration of the maternal pulse. Birth within 1min from the start of the incision is uncommon in these circumstances. KEYWORDS: Cardiopulmonary resuscitation in pregnancy; Maternal cardiac arrest; Maternal mortality; Perimortem cesarean section; Postmortem cesarean section PDF Cesárea perimorten fuera del hospital como histerotomía de resucitación en paro cardiaco materno postraumático Out-of-Hospital Perimortem Cesarean Section as Resuscitative Hysterotomy in Maternal Posttraumatic Cardiac Arrest. Gatti F1, Spagnoli M1, Zerbi SM1, Colombo D2, Landriscina M1, Kette F3. Case Rep Emerg Med. 2014;2014:121562. doi: 10.1155/2014/121562. Epub 2014 Oct 30. Abstract The optimal treatment of a severe hemodynamic instability from shock to cardiac arrest in late term pregnant women is subject to ongoing studies. However, there is an increasing evidence that early "separation" between the mother and the foetus may increase the restoration of the hemodynamic status and, in the cardiac arrest setting, it may raise the likelihood of a return of spontaneous circulation (ROSC) in the mother. This treatment, called Perimortem Cesarean Section (PMCS), is now termed as Resuscitative Hysterotomy (RH) to better address the issue of an early Cesarean section (C-section). This strategy is in contrast with the traditional treatment of cardiac arrest characterized by the maintenance of cardiopulmonary resuscitation (CPR) maneuvers without any emergent surgical intervention. We report the case of a prehospital perimortem delivery by Caesarean (C) section of a foetus at 36 weeks of gestation after the mother's traumatic cardiac arrest. Despite the negative outcome of the mother, the choice of performing a RH seems to represent up to date the most appropriate intervention to improve the outcome in both mother and foetus. PDF  XIII Congreso Virtual Mexicano de Anestesiología Inscripciones Abiertas Octubre a Diciembre 2016 Información / Information L Congreso Mexicano de Anestesiología Noviembre 2-6, 2016 Información / Information 17h World Congress of Anaesthesiologists, WFSA Sep 6-11, 2020 Prague, Czech Republic Informes / Information

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

Biblioteca. Noticias

Biblioteca
Notificaciones semanales ⋅ 12 de octubre de 2016
NOTICIAS

Junta trae de nuevo a la biblioteca provincial 'Los sábados de cuento' durante octubre y noviembre
Lainformacion.com
La biblioteca provincial de Huelva ha puesto nuevo en marcha la iniciativa 'Los sábados de cuento' dirigida a sus socios más pequeños.
Regresa a la Biblioteca Provincial la actividad 'Los sábados de cuento' - Huelva24
Cobertura total de la noticia



CERVANTES CENTENARIO Galatea y Rinconete y Cortadillo se reivindican en laBiblioteca ...
EFE
Porque Cervantes "no es sólo el Quijote", Acción Cultural Española ha inaugurado hoy en la Biblioteca Nacional la exposición "16 personajes que ...
La Biblioteca Nacional acoge una lectura en braille del Quijote en distintos idiomas y de forma ... - Discapnet (Comunicado de prensa)
Cobertura total de la noticia



La ley debe pulir la propuesta para las bibliotecas
El Comercio (Ecuador)
Biblioteca Nacional La Biblioteca Nacional, que está cerrada desde abril de este año, debería convertirse en el ente rector en esta materia.



Carlos Calderón Chico forjó una biblioteca con cerca de 40 mil volúmenes
El Telégrafo
La gran mayoría de los libros de la biblioteca de Carlos Calderón pertenecen a autores nacionales. Foto: Alfredo Piedrahíta / El Telégrafo ...



La Biblioteca Nacional ofrece ser el depósito legal electrónico de autonomías
Yahoo Finanzas España
Logroño, 7 oct (EFE).- La Biblioteca Nacional (BN) ha empezado ya a dar diferentes pasos para convertirse en el depósito legal electrónico de las ...



La nueva Biblioteca Municipal de Manlleu abre las puertas este viernes
La Vanguardia
Una de las nuevas incorporaciones de la Biblioteca Municipal de Manlleu: un espacio dedicado a la música y a las películas (ACN / L. Busquets).



Legisladores promueven crear la biblioteca de la Cámara de Diputados
Terra.com
El presidente de la Comisión Bicameral del Sistema de Bibliotecas, Francisco Xavier Nava Palacios, consideró necesario promover la biblioteca de la ...



La Biblioteca Nacional vuelve a números negros, tras un ajuste contable, y cierra 2015 con un ...
Lainformacion.com
La Biblioteca Nacional de España (BNE) cerró el ejercicio 2015 con una ahorro neto de 669.018 euros, lo que le devuelve a los números negros, tras ...
La Biblioteca Nacional organiza para este sábado una edición colectiva en Wikipedia sobre ... - La Vanguardia
Cobertura total de la noticia



La Biblioteca Pública de Nueva York reabre su extenso salón de lectura
Univision (Comunicado de prensa)
En la Biblioteca Pública de Nueva York hay rincones para cada búsqueda creativa sea leer, investigar o simplemente, disfrutar. Pero muchos echaron ...



Hallan libros de la biblioteca municipal de Gata en el contenedor de papel
El Periódico Extremadura
A su juicio, los libros de la biblioteca "no son del alcalde, ni de la corporación; son del pueblo, son patrimonio cultural de todos los vecinos".
Encuentran decenas de libros de la biblioteca en un contenedor - El Periódico Extremadura
Cobertura total de la noticia

WEB

Búsqueda rápida
lasalle.edu.co
Todas las bibliotecas, BIB-MUSEO, BIB-PIVOT, BIB-YOPAL, BIBLIOTECA ULS, CHAPINERO, LA CANDELARIA, NORTE. Todas las colecciones ...



La BNE en LIBER 2016
Biblioteca Nacional de España
La edición de este año de LIBER, feria del libro que se celebra en Barcelona del 12 al 14 de octubre, acoge dos mesas redondas, moderadas por la ...



Inscripción a la Jornada Virtual Acceso Abierto Argentina
Biblioteca Electrónica de Ciencia y Tecnología - Ministerio de Ciencia, Tecnología e Innovación Productiva
En el marco de la Semana del Acceso Abierto, como todos los años, la la Biblioteca Electrónica de Ciencia y Tecnología del Ministerio de Ciencia, ...



Biblioteca de México
Biblioteca de México
BIBLIOTECAS PERSONALES. Biblioteca José Luis Martínez · Biblioteca Antonio Castro Leal ... LA BIBLIOTECA. Misión, Visión y Objetivos · Historia ...



Cine
Biblioteca Nacional
Ciclo de cine organizado por la Biblioteca Nacional en el marco de la exposición Borges el mismo, otro. En este segundo encuentro, "Screwball ...



Conoce CEDOCIT-México / Biblioteca
Gob.mx
El CEDOCIT (Centro de Documentación de Ciencias de la Tierra) cuenta con una Biblioteca especializada en Ciencias de la Tierra, en la cual se han ...



Aumentamos el número de las renovaciones de préstamo
Biblioteca Universidad de Sevilla
El aumento en el número de renovaciones se realiza en las obras con tipo de préstamo "normal" y en aquellos usuarios con unas condiciones de ...



Los Irlandeses en América Latina
Biblioteca de México
BIBLIOTECAS PERSONALES ... con el apoyo de la Secretaría de Cultura a través de la Biblioteca de México, se complace en presentar la exposición ...



Lanzamiento de "Lluvia y Merlot" en Biblioteca Campus Chillán
Bibliotecas UdeC - Universidad de Concepción
Sergio Recabarren M., Subdirector, Yasna Catalán Ch., Jefa de Biblioteca y el Grupo Literario del Campus Chillán de la Universidad de Concepción, ...



Festival Iberoamericano independiente de Arte Electrónico Ctrl+Ñ
Biblioteca de México
CATÁLOGOS. Catálogo Bibliográfico. Colección General · Bibliotecas Personales ... BIBLIOTECAS PERSONALES.Biblioteca José Luis Martínez ...