Randomized trial comparing ferric carboxymaltose vs oral ferrous glycine sulphate for postoperati... more Randomized trial comparing ferric carboxymaltose vs oral ferrous glycine sulphate for postoperative anaemia after total knee arthroplasty
Revista Española de Anestesiología y Reanimación, 2020
Resumen Antecedentes La implementacion de los programas Patient Blood Management (PBM) es variabl... more Resumen Antecedentes La implementacion de los programas Patient Blood Management (PBM) es variable en Europa, incluso en centros en los que estos programas estan bien establecidos, donde existe variabilidad en cuanto a practicas transfusionales. Objetivos y metodos Realizamos una encuesta para valorar la practica actual sobre PBM perioperatoria en pacientes programados para artroplastia total de cadera y rodilla, entre los investigadores involucrados en el Estudio POWER.2 en Espana (estudio observacional prospectivo que evaluaba las vias de recuperacion intensificada en cirugia ortopedica). Resultados Se obtuvo un total de 322 respuestas (37,8%). El 50% de los respondedores revisaban los niveles de hemoglobina, al menos 4 semanas antes de la cirugia; el 35% trataba a todos los pacientes anemicos, aunque el 99,7% consideraba que la deteccion y tratamiento de la anemia preoperatoria podrian influir en los resultados postoperatorios. La falta de infraestructuras (76%) y la falta de tiempo (51%) fueron los principales motivos para no tratar a los pacientes anemicos. El estatus del hierro es revisado antes de la cirugia por el 19% de manera rutinaria, y el 36% lo evalua unicamente en pacientes anemicos. Hb Conclusiones Los resultados de nuestra encuesta muestran la variabilidad en la practica clinica en PBM en cirugia ortopedica mayor, a pesar de ser el tipo de cirugia con mas tradicion en estos programas.
Revista Española de Anestesiología y Reanimación, 2019
INTRODUCTION The Maturity Assessment Model in Patient Blood Management project involves the use o... more INTRODUCTION The Maturity Assessment Model in Patient Blood Management project involves the use of a matrix that evaluates the maturity of the centre as regards blood transfusion practice. This tool includes a questionnaire to be completed by physicians to determine their level of knowledge of patient blood management strategies in their centre. MATERIAL AND METHODS Forty one hospitals took part in the Maturity Assessment Model in Patient Blood Management project in 2016. The questionnaire included 10 questions, 3 about the centre, specialty, and years of experience, and 7 about patient blood management protocols in the respondent's centre. The minimum responses required per centre was calculated according to the number of beds. Responses from at least 3 different specialties were required in order to be evaluated. RESULTS A total of 1403 questionnaires were completed. The specialty with the highest completion rate was anaesthesiology (40.9%). The distribution as regards professional experience was homogeneous: <10 years, 33.4%, 10-20 years, 33%, and> 20 years 33.6%. Nearly three-quarters (74.2%) knew the patient blood management protocol used in their centre, and 60.7% knew the protocol for the treatment of pre-operative anaemia. Slightly fewer (72%) reported knowing the blood transfusion protocol (transfusion threshold) used in their centre, and 90% considered other factors besides haemoglobin in the decision to transfuse. Only 30.7% of professionals reported receiving periodic information on transfusion practices. CONCLUSIONS There is a significant lack of knowledge about preoperative anaemia and perioperative transfusion protocols used in the centres polled. Few centres provide their physicians with information on transfusion practices.
BACKGROUND AND OBJECTIVE: Preoperative anemia is a major risk factor for perioperative transfusio... more BACKGROUND AND OBJECTIVE: Preoperative anemia is a major risk factor for perioperative transfusion in orthopedic surgery and aging is associated with an increased risk for devoloping anemia. The aim of this study was to compare the efficacy and safety of preoperative ...
Background Preoperative anemia is an important risk factor for perioperative red blood cell trans... more Background Preoperative anemia is an important risk factor for perioperative red blood cell transfusions and has been shown to be independently associated with adverse outcomes after noncardiac surgery. The objective of this observational study was to measure the prevalence of preoperative anemia and assess the relationship between preoperative anemia and postoperative mortality. Methods Data were retrospectively collected on 7,759 consecutive noncardiac surgical patients at the University Health Network between 2003 and 2006. Preoperative anemia was defined as a hemoglobin concentration less than 12.0 g/dl for women and less than 13.0 g/dl for men. The unadjusted and adjusted relationship between preoperative anemia and mortality was assessed using logistic regression and propensity analyses. Results Preoperative anemia was common and equal between genders (39.5% for men and 39.9% for women) and was associated with a nearly five-fold increase in the odds of postoperative mortality....
Revista española de anestesiología y reanimación, 1995
To study the prevalence of positive serology results for hepatitis B and C viruses among patients... more To study the prevalence of positive serology results for hepatitis B and C viruses among patients scheduled for elective orthopedic surgery, to establish risk groups and to assess the economic cost involved in testing patients in such groups. We performed a retrospective study of 1090 preoperative charts for patients awaiting elective orthopedic surgery between November 1993 and January 1995. Variables recorded were age, sex, physical status, history of alcoholism or addiction to injected drugs, associated disease (liver disease, chronic kidney failure and hemodialysis, and coagulation disorders), history of blood products transfusion, preoperative liver enzymes and blood levels of AcVHC and AgVHB as determined by enzyme immunoassay. Mean age was 51.8 (SD 17.5). Women predominated, accounting for 60.6% of the sample. ASA I and ASA II patients accounted for 84.9%, 72 (6.61%) had had previous transfusions, 51 (4.6%) suffered liver disease, 4 (0.36%) had coagulation disorder, 5 (0.45%)...
We report a patient with urinary sepsis who, during intravenous urography with iodinated contrast... more We report a patient with urinary sepsis who, during intravenous urography with iodinated contrast (70 mg Na, Ca diatrizoate and meglumine) developed dyspnea, tachypnea, sinus tachycardia and moderate hypoxemia (pO2: 72 with FiO2 of 0.21). She subsequently developed adult respiratory distress syndrome (ARDS) with refractory hypoxemia (pO2: 40 mmHg with FiO2 of 0.5) and disseminated intravascular coagulation (DIC) (prothrombin index: 5%, platelets: 20,000/mm3, APTT: 102/37 min, FDP: 80 ng/ml, and fibrinogen: 120 mg %). The patient required mechanical ventilation and treatment with inotropic drugs, antibiotics, corticosteroids, plasma, platelets and erythrocytes. The outcome was favorable, and she could be discharged from the Reanimation Service 7 days after admission. In severe systemic reactions to iodinated contrasts (SRIC), ARDS and DIC are common. In our patient, the close temporal association between the administration of iodinated contrast and the development of the clinical pic...
Randomized trial comparing ferric carboxymaltose vs oral ferrous glycine sulphate for postoperati... more Randomized trial comparing ferric carboxymaltose vs oral ferrous glycine sulphate for postoperative anaemia after total knee arthroplasty
Revista Española de Anestesiología y Reanimación, 2020
Resumen Antecedentes La implementacion de los programas Patient Blood Management (PBM) es variabl... more Resumen Antecedentes La implementacion de los programas Patient Blood Management (PBM) es variable en Europa, incluso en centros en los que estos programas estan bien establecidos, donde existe variabilidad en cuanto a practicas transfusionales. Objetivos y metodos Realizamos una encuesta para valorar la practica actual sobre PBM perioperatoria en pacientes programados para artroplastia total de cadera y rodilla, entre los investigadores involucrados en el Estudio POWER.2 en Espana (estudio observacional prospectivo que evaluaba las vias de recuperacion intensificada en cirugia ortopedica). Resultados Se obtuvo un total de 322 respuestas (37,8%). El 50% de los respondedores revisaban los niveles de hemoglobina, al menos 4 semanas antes de la cirugia; el 35% trataba a todos los pacientes anemicos, aunque el 99,7% consideraba que la deteccion y tratamiento de la anemia preoperatoria podrian influir en los resultados postoperatorios. La falta de infraestructuras (76%) y la falta de tiempo (51%) fueron los principales motivos para no tratar a los pacientes anemicos. El estatus del hierro es revisado antes de la cirugia por el 19% de manera rutinaria, y el 36% lo evalua unicamente en pacientes anemicos. Hb Conclusiones Los resultados de nuestra encuesta muestran la variabilidad en la practica clinica en PBM en cirugia ortopedica mayor, a pesar de ser el tipo de cirugia con mas tradicion en estos programas.
Revista Española de Anestesiología y Reanimación, 2019
INTRODUCTION The Maturity Assessment Model in Patient Blood Management project involves the use o... more INTRODUCTION The Maturity Assessment Model in Patient Blood Management project involves the use of a matrix that evaluates the maturity of the centre as regards blood transfusion practice. This tool includes a questionnaire to be completed by physicians to determine their level of knowledge of patient blood management strategies in their centre. MATERIAL AND METHODS Forty one hospitals took part in the Maturity Assessment Model in Patient Blood Management project in 2016. The questionnaire included 10 questions, 3 about the centre, specialty, and years of experience, and 7 about patient blood management protocols in the respondent's centre. The minimum responses required per centre was calculated according to the number of beds. Responses from at least 3 different specialties were required in order to be evaluated. RESULTS A total of 1403 questionnaires were completed. The specialty with the highest completion rate was anaesthesiology (40.9%). The distribution as regards professional experience was homogeneous: <10 years, 33.4%, 10-20 years, 33%, and> 20 years 33.6%. Nearly three-quarters (74.2%) knew the patient blood management protocol used in their centre, and 60.7% knew the protocol for the treatment of pre-operative anaemia. Slightly fewer (72%) reported knowing the blood transfusion protocol (transfusion threshold) used in their centre, and 90% considered other factors besides haemoglobin in the decision to transfuse. Only 30.7% of professionals reported receiving periodic information on transfusion practices. CONCLUSIONS There is a significant lack of knowledge about preoperative anaemia and perioperative transfusion protocols used in the centres polled. Few centres provide their physicians with information on transfusion practices.
BACKGROUND AND OBJECTIVE: Preoperative anemia is a major risk factor for perioperative transfusio... more BACKGROUND AND OBJECTIVE: Preoperative anemia is a major risk factor for perioperative transfusion in orthopedic surgery and aging is associated with an increased risk for devoloping anemia. The aim of this study was to compare the efficacy and safety of preoperative ...
Background Preoperative anemia is an important risk factor for perioperative red blood cell trans... more Background Preoperative anemia is an important risk factor for perioperative red blood cell transfusions and has been shown to be independently associated with adverse outcomes after noncardiac surgery. The objective of this observational study was to measure the prevalence of preoperative anemia and assess the relationship between preoperative anemia and postoperative mortality. Methods Data were retrospectively collected on 7,759 consecutive noncardiac surgical patients at the University Health Network between 2003 and 2006. Preoperative anemia was defined as a hemoglobin concentration less than 12.0 g/dl for women and less than 13.0 g/dl for men. The unadjusted and adjusted relationship between preoperative anemia and mortality was assessed using logistic regression and propensity analyses. Results Preoperative anemia was common and equal between genders (39.5% for men and 39.9% for women) and was associated with a nearly five-fold increase in the odds of postoperative mortality....
Revista española de anestesiología y reanimación, 1995
To study the prevalence of positive serology results for hepatitis B and C viruses among patients... more To study the prevalence of positive serology results for hepatitis B and C viruses among patients scheduled for elective orthopedic surgery, to establish risk groups and to assess the economic cost involved in testing patients in such groups. We performed a retrospective study of 1090 preoperative charts for patients awaiting elective orthopedic surgery between November 1993 and January 1995. Variables recorded were age, sex, physical status, history of alcoholism or addiction to injected drugs, associated disease (liver disease, chronic kidney failure and hemodialysis, and coagulation disorders), history of blood products transfusion, preoperative liver enzymes and blood levels of AcVHC and AgVHB as determined by enzyme immunoassay. Mean age was 51.8 (SD 17.5). Women predominated, accounting for 60.6% of the sample. ASA I and ASA II patients accounted for 84.9%, 72 (6.61%) had had previous transfusions, 51 (4.6%) suffered liver disease, 4 (0.36%) had coagulation disorder, 5 (0.45%)...
We report a patient with urinary sepsis who, during intravenous urography with iodinated contrast... more We report a patient with urinary sepsis who, during intravenous urography with iodinated contrast (70 mg Na, Ca diatrizoate and meglumine) developed dyspnea, tachypnea, sinus tachycardia and moderate hypoxemia (pO2: 72 with FiO2 of 0.21). She subsequently developed adult respiratory distress syndrome (ARDS) with refractory hypoxemia (pO2: 40 mmHg with FiO2 of 0.5) and disseminated intravascular coagulation (DIC) (prothrombin index: 5%, platelets: 20,000/mm3, APTT: 102/37 min, FDP: 80 ng/ml, and fibrinogen: 120 mg %). The patient required mechanical ventilation and treatment with inotropic drugs, antibiotics, corticosteroids, plasma, platelets and erythrocytes. The outcome was favorable, and she could be discharged from the Reanimation Service 7 days after admission. In severe systemic reactions to iodinated contrasts (SRIC), ARDS and DIC are common. In our patient, the close temporal association between the administration of iodinated contrast and the development of the clinical pic...
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