ABSTRACT
Las lesiones traumáticas, así como ciertas enfermedades congénitas y adquiridas, producen a veces inestabilidad cervical. Dado que el tratamiento de la vía aérea está íntimamente relacionado con el movimiento de la columna cervical, el médico anestesiólogo debe conocer en detalle la anatomía, los diferentes mecanismos de inestabilidad cervical, y los efectos que las maniobras de la vía aérea producen sobre la columna. El presente artículo se dedicará, en una primera parte, a la anatomía y biomecánica de la columna cervical en relación con la instrumentación de la vía aérea y a las clases de inestabilidad más relevantes. En la segunda parte se repasarán los protocolos para el estudio de pacientes con posible inestabilidad cervical traumática y algunas de las opciones para el tratamiento de la vía aérea en estos pacientes (AU)
Many congenital and acquired diseases, including trauma, may result in cervical spine instability. Given that airway managament is closely related to the movement of the cervical spine, it is important that the anesthesiologist has detailed knowledge of the anatomy, the mechanisms of cervical spine instability, and of the effects that the different airway maneveuvers have on the cervical spine. We first review the normal anatomy and biomechanics of the cervical spine in the context of airway management and the concept of cervical spine instability. In the second part, we review the protocols for the management of cervical spine instability in trauma victims and some of the airway management options for these patiens (AU)
Subject(s)
Humans , Joint Instability/complications , Arthritis, Rheumatoid/complications , Airway Management/methods , Intubation, Intratracheal/methodsABSTRACT
Many congenital and acquired diseases, including trauma, may result in cervical spine instability. Given that airway management is closely related to the movement of the cervical spine, it is important that the anesthesiologist has detailed knowledge of the anatomy, the mechanisms of cervical spine instability, and of the effects that the different airway maneuvers have on the cervical spine. We first review the normal anatomy and biomechanics of the cervical spine in the context of airway management and the concept of cervical spine instability. In the second part, we review the protocols for the management of cervical spine instability in trauma victims and some of the airway management options for these patients.
Subject(s)
Airway Management/methods , Airway Obstruction/etiology , Cervical Vertebrae/physiopathology , Joint Instability/physiopathology , Atlanto-Axial Joint/physiopathology , Atlanto-Occipital Joint/physiopathology , Biomechanical Phenomena , Humans , Joint Dislocations/physiopathology , Ligaments/physiopathology , Motion , Musculoskeletal Diseases/physiopathology , Neck Muscles/physiopathology , Neuromuscular Diseases/physiopathology , Range of Motion, Articular , Wounds and Injuries/physiopathology , Wounds and Injuries/therapyABSTRACT
Los barorreflejos, los reflejos mediados por quimiorreceptores, los reflejos mediados por estimulación pulmonar, el reflejo de Bezold-Jarish, el reflejo de Bainbridge y la interacción de estos con mecanismos de regulación locales son una demostración de la riqueza en las respuestas cardiovasculares que rigen en los seres humanos. Junto a ellos, el anestesiólogo debe a su vez afrontar muchas otras variables que los acentúan o modifican, como los fármacos anestésicos, la manipulación quirúrgica, la posición en la que se realiza la cirugía y la medicación que consume el paciente, que entran en juego para alterar el control cardiovascular. En el presente artículo procedemos a describir cada uno de los reflejos cardiopulmonares, sus interacciones e implicación en la anestesiología(AU)
Subject(s)
Humans , Male , Female , Baroreflex , Baroreflex/physiology , Anesthesia/methods , Anesthesia , Anesthesiology/classification , Anesthesiology/methodsSubject(s)
Catheterization, Swan-Ganz/instrumentation , Pulmonary Artery , Aged , Equipment Failure , Female , HumansABSTRACT
The baroreflex, chemoreflex, pulmonary reflexes, Bezold-Jarisch and Bainbridge reflexes and their interaction with local mechanisms, are a demonstration of the richness of cardiovascular responses that occur in human beings. As well as these, the anesthesiologist must contend with other variables that interact by attenuating or accentuating cardiopulmonary reflexes such as, anesthetic drugs, surgical manipulation, and patient positioning. In the present article we review these reflexes and their clinical relevance in anesthesiology.
Subject(s)
Anesthesia , Heart/physiology , Lung/physiology , Reflex , Baroreflex , Carotid Body/physiology , HumansABSTRACT
Chagas' disease is an endemic parasitic illness in the American continent, affecting around 16 to 18 million people. Given that 9.5% of immigrants to Italy are from Latin America and that the infection can be transmitted in non-endemic countries congenitally by organ donations and blood transfusions, Chagas disease should be regarded as an emerging public health problem in Italy. Clinical guidelines as well as health protocols are needed to deal with this rarely recognized disease.
