Actualizaciones en Anestesiologia y Reanimacion
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ABSTRACT: Pheochromocytomas are rare neuroendocrine tumors with a highly variable clinical presentation usually includes high blood pressure, headache and sweating. Patients with pheochromocytoma may develop potentially lethal cardiovascular complications without adequate perioperative management, including cardiomyopathy. These complications are due to the secretion of catecholamines. During the preoperative period the patient should be prepared pharmacologically to prevent a hypertensive crisis during surgery. Three intraoperative periods are the most critical for the patient: intubation, surgical manipulation of the tumor and ligation of venous drainage of the tumor. The first two are associated with catecholamine release, and the latter to a relative deficiency of these; this stage after tumor resection is characterized by a severe hypotension requiring anesthesiologic care as their consequences can become serious complications . Knowledge of the alterations caused by the secretion of catecholamines and therapeutic options for treatment are essential to reduce the risk in this surgery, which is a challenge for the anesthesiologist.Actualizaciones en Anestesiologia y Reanimacion 06/2013; 23(3).
Actualizaciones en Anestesiologia y Reanimacion 01/2012; 22(4).
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ABSTRACT: Gas analysers are based on physical principles. They improve accuracy; they can provide continuous breath-to-breath measurement. We describe infrared absorption, ultraviolet absorption, thermal conductivity, electrode of CO 2, electrodes transcutaneous, intravascular probes and end tidal CO2 measurement. Copyright © 2010 Aran Ediciones, s. l.Actualizaciones en Anestesiologia y Reanimacion 01/2010; 20(1):4-10.
Actualizaciones en Anestesiologia y Reanimacion 01/2010; 20(1):38-39.
Article: Oxigen level monitoring[Show abstract] [Hide abstract]
ABSTRACT: Monitoring of respiratory gases (oxygen, carbon dioxide, nitrous oxide, volatile agents), is considered highly important for the practice of anaesthesia and also a standard monitoring technique during anaesthesia. Paramagnetic oxygen analysers are the most common form of oxygen analyser used for monitoring inspired oxygen levels. Paramagnetic and mass spectrometer methods are suitable for analysis of respiratory gas mixtures. Fuel cell and polarographic methods are suitable for blood gas analysis. Mass spectrometry is a very accurate technique. Copyright © 2009 Aran Ediciones, S. L.Actualizaciones en Anestesiologia y Reanimacion 01/2009; 19(3):98-104.
Article: Obstetric haemorrhage[Show abstract] [Hide abstract]
ABSTRACT: Massive obstetric haemorrhage is a very important cause of maternal morbidity and mortality in developed countries and in third world countries. Massive obsteric haemorrhage has a coagulopathic component and a vascular or surgical component that are often associated in the same patient. Nearly two thirds of patients cannot be identified with risk factors for obstetric haemorrhage, although a good knowledge and early identification of associated risk factors is helpful for its prevention in many cases. Obstetric haemorrhage is not always adequately identified or treated, because blood loss is underestimated by clinical observation. Postpartum haemorrhage is the cause of 95% of all obstetric haemorrhages. In this group, the main cause is uterine atony. Women's resuscitation objective is thr intravascular volume restoration, to reach and adequate tissue perfussion pressure. Once an obstetric haemorrhage is diagnosed, it is very important a coordinated, rapid and protocolized treatment. Rational use of blood components, team work with the blood bank, the use of pharmacological and surgical resources readily, are necessary actions in this context. It is highly recommended prompt implication of senior staff in severe obstetric haemorrhage resolution. It is recommended the use of local protocols for each maternity. This protocol must be known by all team members and it must be adapted to local hospital characteristics, and should be periodically revised. High risk patients for obstetric haemorrhage, must be transferred to a level III hospital where all resources can be used if necessary. Copyright © 2009 Aran Ediciones, S. L.Actualizaciones en Anestesiologia y Reanimacion 01/2009; 19(2):49-60.
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ABSTRACT: Labour pain is individually felt by women and it can be the most painful experience that a woman can feel in all the life. That is the reason because the analgesic offer for labour pain should be wide and adapted to individual needs and adapted too to the environmental conditions (hospital and not hospital labour). The most effective technique for labour pain is epidural or neuraxial analgesia. This technique is sometimes unavailable for different reasons, such as: contraindication, not available in hospital, and woman's refusal. Non pharmacological techniques can be offered to laboring women, as example: acupuncture, massage, emotional support, etc. Its efficacy is variable and not completely studied. Systemic analgesia is another analgesic option and we remark the use of pethidine, as the most popular opioid for labour pain, and remifentanil, as a recently developed analgesic option. Self-administered inhalatory drugs have been commonly used in United Kingdom in the last century, although its use in Spain is nowadays unusual. Opioids and inhalatory drugs must be delivered in a hospital, with protocols and specialist medical care, what means the anesthesiologist guard duty. Copyright © 2009 Aran Ediciones, S. L.Actualizaciones en Anestesiologia y Reanimacion 01/2009; 19(3):105-112.
Actualizaciones en Anestesiologia y Reanimacion 03/1994; 4(3):150-60.
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