0000000000184335
AUTHOR
Rosario Vicente
Supplemental Perioperative Oxygen and the Risk of Surgical Wound Infection<SUBTITLE>A Randomized Controlled Trial</SUBTITLE>
ContextSupplemental perioperative oxygen has been variously reported to halve or double the risk of surgical wound infection.ObjectiveTo test the hypothesis that supplemental oxygen reduces infection risk in patients following colorectal surgery.Design, Setting, and PatientsA double-blind, randomized controlled trial of 300 patients aged 18 to 80 years who underwent elective colorectal surgery in 14 Spanish hospitals from March 1, 2003, to October 31, 2004. Wound infections were diagnosed by blinded investigators using Centers for Disease Control and Prevention criteria. Baseline patient characteristics, anesthetic treatment, and potential confounding factors were recorded.InterventionsPati…
Predictors of mortality and early detection strategies for hepatopulmonary syndrome in liver transplant patients☆
Introduction: Hepatopulmonary syndrome (HPS) is a serious, progressive disease. Its pathophysiology resides in a hypoxic intrapulmonary shunt and severe clinical deterioration. Liver transplantation (LT) is the only effective treatment in appropriately selected patients. Objective: To acknowledge the importance of early diagnosis of HPS. Patients and methods: Observational, descriptive, retrospective trial including 8 patients with HPS that received LT between April 2006 and August 2014. The clinical data prior to transplantation and follow-up after the procedure were reviewed. A multivariate analysis (stepwise forward logistic regression analysis) was used to identify the variable that cou…
Factores predictores de mortalidad y estrategias de detección precoz de síndrome hepatopulmonar en pacientes trasplantados hepáticos
ResumenIntroducciónEl síndrome hepatopulmonar (SHP) es una enfermedad grave y progresiva cuya fisiopatología reside en un shunt intrapulmonar con hipoxia y deterioro clínico severo. Como único tratamiento efectivo se ha postulado el trasplante hepático (TH), en pacientes adecuadamente seleccionados.ObjetivoReconocer la importancia del diagnóstico temprano del SHP.Pacientes y métodosMediante un estudio observacional, descriptivo, con carácter retrospectivo de 8 pacientes con SHP, a los que se les realizó TH en el período entre abril del 2006 y agosto del 2014. Se han revisado los datos clínicos previos al trasplante y el seguimiento tras este.Se empleó un estudio multivariante (stepwise forw…
Effects of inhaled nitric oxide on primary graft dysfunction in lung transplantation.
Introduction and Objectives. Inhaled nitric oxide (iNO) is a gaseous drug with known properties of specific pulmonary vasodilation and improved oxygenation. In some clinical trials on lung transplantation (LT) in animals, it has been demonstrated to reduce primary graft dysfunction (PGD) by limiting neutrophil adhesion and the inflammatory cascade. Our objective was to assess whether iNO showed this immunomodulatory effect by determining interleukin (IL)-6, -8, and -10 levels in blood and bronchoalveolar lavage (BAL) in LT patients, and its relationship with PGD incidence. Materials and Methods. Forty-nine LT patients were recruited and included in the iNO or in the control group. Patients …
Guía clínica en el manejo perioperatorio para la cirugía de resección pulmonar por videotoracoscopia (Sección de Anestesia Cardiaca, Vascular y Torácica, SEDAR; Sociedad Española de Cirugía Torácica, SECT; Asociación Española de Fisioterapia, AEF)
Resumen La introduccion de tecnicas toracoscopicas asistidas por video en cirugia toracica (VATS) ha permitido realizar un nuevo enfoque en la cirugia toracica. El acceso videotoracoscopico se realiza con pequenas incisiones, preservando al maximo los musculos y los tejidos. En la actualidad, la VATS se considera de eleccion en la mayoria de los procedimientos toracicos, principalmente debido a la menor morbimortalidad asociada. La reseccion pulmonar por VATS presenta reduccion de las fugas de aire prolongadas, arritmias, neumonia, dolor postoperatorio y una disminucion de los marcadores inflamatorios. Esta reduccion de las complicaciones postoperatorias esta vinculada a una reduccion de la…
Analysis and review of the perioperative management of COVID-19 patients in thoracic surgery.
Resumen Debido a la grave situacion de pandemia que vivimos causada por el COVID-19, la Seccion de Anestesia Cardiaca, Vascular y Toracica de la SEDAR pretende dar informacion de los aspectos mas relevantes a considerar en pacientes con sospecha o infeccion confirmada por coronavirus que van a ser sometidos a cirugia toracica. Creemos que es esencial mantener una optima transmision de informacion para llevar a cabo maniobras seguras, tanto para los pacientes como para el personal sanitario. La estrategia de manejo debe basarse en una organizacion exquisita del trabajo, definiendo quien, como y cuando va a realizar cada tarea y procedimiento. Las recomendaciones que se proponen, tras valorar…
Analysis of interleukin-6 and interleukin-8 in lung transplantation: correlation with nitric oxide administration.
Introduction and Objectives. Primary graft dysfunction (PGD) following lung transplantation (LT) is associated with an activation of the inflammatory cascade and release of cytokines. Inhaled nitric oxide (iNO) provides specific pulmonary vasodilatation and improves oxygenation. Our objective was to verify whether administering iNO to LT patients modified the blood and bronchoalveolar lavage (BAL) interleukin (IL)-6 and -8 levels in the event of PGD. Materials and Methods. Thirty-two LT patients were randomized to the iNO treatment or the control group. Patients in the first group were given 10 ppm of iNO from the start of LT until 48 hours afterward. BAL and peripheral arterial blood sampl…
Supplemental Perioperative Oxygen and the Risk of Surgical Wound Infection: A Randomized Controlled Trial
ABSTRACT Three hundred patients were enrolled in a double-blind, randomized, controlled study designed to investigate the ability of supplemental perioperative oxygen to reduce wound infection. Participants were age 18 to 80 years, had no coexisting serious medical conditions, and were scheduled to undergo elective colorectal surgery at one of 14 participating hospitals in Spain. No patients undergoing minor or laparoscopic surgery were included. Anesthesia and antibiotic prophylaxis were standardized for the study. Patients were randomized by computer-generated codes to receive an oxygen/air mixture of 30% or 80% fraction of inspired oxygen (F102) intraoperatively and postoperatively for 6…