Share
array:24 [ "pii" => "S2341192922000993" "issn" => "23411929" "doi" => "10.1016/j.redare.2022.06.005" "estado" => "S300" "fechaPublicacion" => "2022-06-01" "aid" => "1353" "copyright" => "Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor" "copyrightAnyo" => "2021" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Revista Española de Anestesiología y Reanimación (English Version). 2022;69:377-8" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S003493562100205X" "issn" => "00349356" "doi" => "10.1016/j.redar.2021.06.001" "estado" => "S300" "fechaPublicacion" => "2022-06-01" "aid" => "1353" "copyright" => "Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Rev Esp Anestesiol Reanim. 2022;69:377-8" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "es" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Carta al Director</span>" "titulo" => "Oportunidades clínicas y organizativas en el manejo de pacientes críticos en la pandemia COVID-19" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "377" "paginaFinal" => "378" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Clinical and organizational opportunities in the management of critical patients in pandemic COVID-19" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "M. Varela-Durán, M. Martínez-Pillado" "autores" => array:2 [ 0 => array:2 [ "nombre" => "M." "apellidos" => "Varela-Durán" ] 1 => array:2 [ "nombre" => "M." "apellidos" => "Martínez-Pillado" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2341192922000993" "doi" => "10.1016/j.redare.2022.06.005" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341192922000993?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S003493562100205X?idApp=UINPBA00004N" "url" => "/00349356/0000006900000006/v1_202205240628/S003493562100205X/v1_202205240628/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S2341192922000981" "issn" => "23411929" "doi" => "10.1016/j.redare.2021.05.013" "estado" => "S300" "fechaPublicacion" => "2022-06-01" "aid" => "1347" "copyright" => "Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Revista Española de Anestesiología y Reanimación (English Version). 2022;69:379" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Image of the month</span>" "titulo" => "Delayed recovery of consciousness after anesthesia" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "379" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Pérdida de conciencia en el postoperatorio inmediato" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 593 "Ancho" => 1005 "Tamanyo" => 63238 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A. Brain CT scan showing an extensive area of vasogenic oedema (yellow arrow) in the right fronto-parietotemporal region enclosing a 46 × 39 × 59 mm space-occupying lesion (blue arrow) with peripheral hyper-uptake of contrast (ring enhancing lesion).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "R. López Herrero, P. Rubio Babiano, B. Sánchez Quirós, C. del Rey de Cabo" "autores" => array:4 [ 0 => array:2 [ "nombre" => "R." "apellidos" => "López Herrero" ] 1 => array:2 [ "nombre" => "P." "apellidos" => "Rubio Babiano" ] 2 => array:2 [ "nombre" => "B." "apellidos" => "Sánchez Quirós" ] 3 => array:2 [ "nombre" => "C." "apellidos" => "del Rey de Cabo" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0034935621001857" "doi" => "10.1016/j.redar.2021.05.014" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0034935621001857?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341192922000981?idApp=UINPBA00004N" "url" => "/23411929/0000006900000006/v1_202207050820/S2341192922000981/v1_202207050820/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2341192922000944" "issn" => "23411929" "doi" => "10.1016/j.redare.2021.09.003" "estado" => "S300" "fechaPublicacion" => "2022-06-01" "aid" => "1389" "copyright" => "Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Revista Española de Anestesiología y Reanimación (English Version). 2022;69:374-6" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Director</span>" "titulo" => "Effect of the first wave of COVID-19 on the implementation of Enhanced Recovery After Surgery (ERAS) protocols based on perceptions of healthcare professionals" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "374" "paginaFinal" => "376" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Efecto de la primera ola de la pandemia COVID-19 en la aplicación de los protocolos de recuperación intensificada perioperatoria según la percepción de los profesionales sanitarios" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1508 "Ancho" => 2091 "Tamanyo" => 96651 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Respondents' perception of adherence to ERAS protocols before and after the pandemic (<span class="elsevierStyleItalic">Minimum: 1, Maximum: 10</span>).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "J.V. Lorente, J. Ripollés-Melchor, C. Aldecoa, A. Abad-Motos" "autores" => array:4 [ 0 => array:2 [ "nombre" => "J.V." "apellidos" => "Lorente" ] 1 => array:2 [ "nombre" => "J." "apellidos" => "Ripollés-Melchor" ] 2 => array:2 [ "nombre" => "C." "apellidos" => "Aldecoa" ] 3 => array:2 [ "nombre" => "A." "apellidos" => "Abad-Motos" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0034935621002681" "doi" => "10.1016/j.redar.2021.09.009" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0034935621002681?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341192922000944?idApp=UINPBA00004N" "url" => "/23411929/0000006900000006/v1_202207050820/S2341192922000944/v1_202207050820/en/main.assets" ] "en" => array:15 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Director</span>" "titulo" => "Clinical and organizational opportunities in the management of critical patients in pandemic COVID-19" "tieneTextoCompleto" => true "saludo" => "To the Editor:" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "377" "paginaFinal" => "378" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "M. Varela-Durán, M. Martínez-Pillado" "autores" => array:2 [ 0 => array:4 [ "nombre" => "M." "apellidos" => "Varela-Durán" "email" => array:1 [ 0 => "modesto.martinez.pillado@sergas.es" ] "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "M." "apellidos" => "Martínez-Pillado" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] ] ] ] "afiliaciones" => array:4 [ 0 => array:3 [ "entidad" => "Servicio de Anestesia y Reanimación, Complexo Hospitalario Universitario de Pontevedra] (CHOP), Sergas, Pontevedra, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Grupo de Investigación (5), Instituto de Investigación Sanitaria Galicia Sur (IIS Galicia Sur), SERGAS-UVIGO, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Unidad de Calidad, Área Sanitaria de Pontevedra e O Salnés, Unidad de Calidade, Complexo Hospitalario Universitario de Pontevedra] (CHOP), Sergas, Pontevedra, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Grupo de Investigación (E Health en Areas Integradas]), Instituto de Investigación Sanitaria Galicia Sur (IIS Galicia Sur), SERGAS-UVIGO, Spain" "etiqueta" => "d" "identificador" => "aff0020" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Oportunidades clínicas y organizativas en el manejo de pacientes críticos en la pandemia COVID-19" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">In September 2019, the World Health Organization warned that “the world faces increasing and more complex epidemics, pandemics and disasters” and is “not prepared for a fast-moving, virulent respiratory pathogen pandemic”. The speed of transmission, the unexpected lethality, and the novelty of facing an event of the magnitude of COVID-19 has placed us in a hitherto unknown organizational situation. The pandemic has affected people of all ages, has involved all organ systems, and has placed healthcare workers in danger of infection. All this has put the public focus on the treatment of critical patients — in short, the entire Health System has undergone a stress test.</p><p id="par0010" class="elsevierStylePara elsevierViewall">The demand made by a group of investigators to evaluate the measures implemented during the pandemic should encourage us to identify the issues and opportunities that will help us evaluate our own outcomes. Contrary to expectations, the pandemic has opened up opportunities for improvement that must not be missed. These opportunities, however, raise "powerful" questions on how to deal with potential new outbreaks.</p><p id="par0015" class="elsevierStylePara elsevierViewall">The pandemic has brought risk management to the fore. Critical care teams have attempted to implement contingency plans<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> to minimize the clinical risks<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a>. The first thing we have learnt<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> is that risk-based thinking across the entire critical care unit compels us to manage cases based on analysing and coping with risks. Another thing we have learnt is the need to make effective use of our talent. Situational leaders have emerged when they were most needed. Multidisciplinary teams have completely overhauled overly rigid organizational structures. How can we make the best use of these situational leaders who take a whole new approach to established working methods?</p><p id="par0020" class="elsevierStylePara elsevierViewall">Given the need to maintain differentiated flows while improving clinical safety, we expedited changes and took decisions that led to an exponential increase in critical resources. The pandemic has given us the opportunity to improve resource management. We have achieved a level of cooperation that has allowed us to implement solutions we would never have though possible before we passed this stress test. Can we learn from the way we have managed exceptional situations?<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">Let us not forget the leading role played by hospitals<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a>. A networked healthcare response is beneficial for patients. Stronger community care helps us improve as professionals and respond from a more populational perspective. A healthcare system spearheaded by primary care will help optimise this networked healthcare response.</p><p id="par0030" class="elsevierStylePara elsevierViewall">Another thing we have learnt is to anticipate events in the short term, turning all the accumulated data into information that can guide decision making.</p><p id="par0035" class="elsevierStylePara elsevierViewall">Given the current focus on major (ethical) decisions, a strategic alliance must be forged between hospital managers and healthcare workers who discover that they work better in an organization that makes them better professionals, and where management and staff have each other’s backs.</p><p id="par0040" class="elsevierStylePara elsevierViewall">We need to manage the future, instead of looking to the past. Using artificial intelligence and implicating physicists, mathematicians and engineers in healthcare will help us improve of critical care management. There is nothing better than sharing our contingency plans and pooling our problems to find the best way approach to exceptional situations. Identifying and learning from those who have achieved better outcomes in the management of COVID 19 patients is an opportunity we cannot let miss as the pandemic starts to abate.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Funding</span><p id="par0045" class="elsevierStylePara elsevierViewall">No external funding.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Funding" ] 1 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2021-05-25" "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Varela-Durán M, Martínez-Pillado M. Oportunidades clínicas y organizativas en el manejo de pacientes críticos en la pandemia COVID-19. Rev Esp Anestesiol Reanim. 2022;69:377–378.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Recomendaciones de consenso respecto al soporte respiratorio no invasivo en el paciente adulto con insuficiencia respiratoria aguda secundaria a infección por SARS-CoV-2" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "C. Cinesi Gómez" 1 => "Ó. Peñuelas Rodríguez" 2 => "M.I. Luján Torné" 3 => "C. Egea Santaolalla" 4 => "J.F. Masa Jiménez" 5 => "J. García Fernández" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Rev Esp Anestesiol Reanim" "fecha" => "2020" "volumen" => "67" "paginaInicial" => "261" "paginaFinal" => "270" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Implicación en Cataluña de los Servicios de Anestesiología y Reanimación en la pandemia por SARS-CoV-2. Una solución real coste-efectiva para una crisis sanitaria sin precedentes]" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "R.M. Villalonga Vadell" 1 => "X. Sala Blanch" 2 => "J. Roigé Solé" 3 => "X. Garcia Eroles" 4 => "C. Morros Viñoles" 5 => "R. Valero Castell" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.redare.2020.05.016" "Revista" => array:5 [ "tituloSerie" => "Rev Esp Anestesiol Reanim" "fecha" => "2021" "volumen" => "68" "paginaInicial" => "114" "paginaFinal" => "116" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Anestesiología y los anestesiólogos en la COVID-19" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "C. Ferrando" 1 => "M.J. Colomina" 2 => "C.L. Errando" 3 => "J.V. Llaub" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Rev Esp Anestesol Reanim" "fecha" => "2020" "volumen" => "67" "paginaInicial" => "289" "paginaFinal" => "291" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Efectividad del plan de contingencia de la Unidad de Enfermedad Inflamatoria Intestinal ante la infección de Covid-19" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "D. Carpio López" 1 => "M. Martínez Pillado" 2 => "Á. Salgado Barreira" 3 => "S. Daponte Angueira" 4 => "R. Díez Lage" 5 => "E. Castro Ortiz" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:3 [ "tituloSerie" => "Rev Esp Salud Pública" "fecha" => "2020" "volumen" => "94" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Documento de consenso de la Sociedad Española de Medicina Intensiva, Crítica, y Unidades Coronarias (SEMICYUC), la Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello (SEORL-CCC) y la Sociedad Española de Anestesiología y Reanimación (SEDAR) sobre la traqueotomía en pacientes con COVID-19" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "R. Villalonga Vadell" 1 => "M.C. Martín Delgado" 2 => "F.X. Avilés-Jurado" 3 => "J. Álvarez Escudero" 4 => "C. Aldecoa Álvarez-Santuyano" 5 => "C. de Haro López" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.redar.2020.05.001" "Revista" => array:5 [ "tituloSerie" => "Rev Esp Anestesiol Reanim" "fecha" => "2020" "volumen" => "67" "paginaInicial" => "504" "paginaFinal" => "510" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/23411929/0000006900000006/v1_202207050820/S2341192922000993/v1_202207050820/en/main.assets" "Apartado" => array:4 [ "identificador" => "66474" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letter to the Director" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23411929/0000006900000006/v1_202207050820/S2341192922000993/v1_202207050820/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341192922000993?idApp=UINPBA00004N" ]
