Revista española de anestesiología y reanimación
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Rev Esp Anestesiol Reanim · May 2015
Case Reports[Anaesthetic management in a paediatric patient with a difficult airway due to epidermolysis bullosa dystrophica].
Dystrophic epidermolysis bullosa (DEB) is a rare inherited disorder characterized by blistering after minimal trauma. These blisters tend to form dystrophic scars, leading to limiting and life-threatening sequelae. The anaesthetic management of patients with DEB is a challenge, even for the most experienced anaesthesiologists, but basic principles can help us prepare the plan of care. ⋯ Besides the implications of the comorbidities, there is a potential difficult intubation and difficult vascular access. Acute airway obstruction can occur due to airway instrumentation. We report the case of a patient diagnosed with EBD difficult airway and undergoing correction of syndactylyl and dental extractions.
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Cryoprecipitate is a plasma derivative rich in fibrinogen and other procoagulant factors. It has been successfully used for decades in the treatment of the coagulopathy of trauma patients, cardiovascular surgery, liver failure and disseminated intravascular coagulation. ⋯ As a consequence, many of the younger anaesthesiologists did not have any direct experience with cryoprecipitate. This article aims to describe the characteristics of cryoprecipitate since it is a different product from manufactured fibrinogen concentrate, with its own specific indications that deserve to be further studied in clinical trials.
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Rev Esp Anestesiol Reanim · Apr 2015
Comparative StudyRenal and hepatic integrity in long-term sevoflurane sedation using the anesthetic conserving device: a comparison with intravenous propofol sedation in an animal model.
Critically ill patients are sedated with intravenous agents because the use of inhaled agents is limited by their potential risk of toxicity. Increasing levels of inorganic fluorides after the metabolism of these agents have been considered potentially nephrotoxic. However, hepatic involvement after prolonged administration of sevoflurane has not yet been studied. The present study evaluated the potential renal and hepatic toxicity caused by prolonged administration (72h) of sevoflurane. ⋯ Long-term sedation with sevoflurane using AnaConDa™ or propofol does not negatively affect renal or hepatic function.