<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0484-7903</journal-id>
<journal-title><![CDATA[Revista mexicana de anestesiología]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. mex. anestesiol.]]></abbrev-journal-title>
<issn>0484-7903</issn>
<publisher>
<publisher-name><![CDATA[Colegio Mexicano de Anestesiología A.C.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0484-79032025000300193</article-id>
<article-id pub-id-type="doi">10.35366/120428</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Implementación de CALS y entrenamiento basado en simulación en el paciente postoperado de cirugía cardíaca: experiencia, evidencia y retos]]></article-title>
<article-title xml:lang="en"><![CDATA[Implementation of CALS and simulation-based training in the postoperative cardiac surgery patient: experience, evidence, and challenges]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Herrera-Elizalde]]></surname>
<given-names><![CDATA[Rafael Eduardo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Núñez-Trejo]]></surname>
<given-names><![CDATA[Pablo de Jesús]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Molina-Torres]]></surname>
<given-names><![CDATA[María del Carmen]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,REASEL (Reanimación en Situaciones Especiales en Latinoamérica)  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>México</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,CALS Latinoamérica  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>México</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Instituto Nacional de Pediatría Centro del Corazón ABC Kardias ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>México</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>09</month>
<year>2025</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>09</month>
<year>2025</year>
</pub-date>
<volume>48</volume>
<numero>3</numero>
<fpage>193</fpage>
<lpage>196</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S0484-79032025000300193&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S0484-79032025000300193&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S0484-79032025000300193&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen: El paro cardíaco en el postoperatorio de cirugía cardíaca demanda un abordaje distinto al Advanced Cardiovascular Life Support (ACLS) convencional, dada la presencia de taponamiento, hemorragia intratorácica o fallas de marcapasos epicárdico. El programa CALS/CSU-ALS propone maniobras específicas, como la triple descarga en fibrilación ventricular/taquicardia ventricular (FV/TV), el uso cauto de adrenalina y la reesternotomía emergente antes de cinco minutos. En este contexto, Simulanest ha demostrado ser un pilar fundamental para la formación, al ofrecer escenarios de simulación de alta fidelidad que potencian las competencias técnicas y la regulación emocional del equipo ante estas crisis. Así, se refuerza la conciencia situacional y la ejecución de protocolos estandarizados. Estudios recientes revelan que la certificación CSU-ALS reduce la mortalidad (FTR-CA) en centros que adoptan este enfoque, gracias a la rápida detección de causas mecánicas y la intervención quirúrgica oportuna. De cara al futuro, la integración de ecocardiografía y soporte circulatorio (ECMO) consolidará aún más la eficacia de CALS en el postoperatorio cardíaco.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract: Cardiac arrest (CA) in the postoperative period after cardiac surgery requires a different approach to conventional Advanced Cardiovascular Life Support (ACLS), given the presence of tamponade, intrathoracic bleeding or epicardial pacemaker failure. The CALS/CSU-ALS program proposes specific maneuvers, such as triple shock in VF/VT, cautious use of adrenaline and emergent resternotomy before five minutes. In this context, Simulanest has proven to be a fundamental pillar for training, offering high-fidelity simulation scenarios that enhance the technical competencies and emotional regulation of the team in the face of these crises. This reinforces situational awareness and the execution of standardized protocols. Recent studies reveal that CSU-ALS certification reduces mortality (FTR-CA) in centers adopting this approach, thanks to rapid detection of mechanical causes and timely surgical intervention. Looking ahead, the integration of echocardiography and circulatory support (ECMO) will further consolidate the efficacy of CALS in the cardiac postoperative period.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[paro cardíaco postoperatorio]]></kwd>
<kwd lng="es"><![CDATA[CALS]]></kwd>
<kwd lng="es"><![CDATA[simulación clínica]]></kwd>
<kwd lng="es"><![CDATA[cirugía cardíaca]]></kwd>
<kwd lng="es"><![CDATA[fracaso de rescate]]></kwd>
<kwd lng="en"><![CDATA[postoperative cardiac arrest]]></kwd>
<kwd lng="en"><![CDATA[CALS]]></kwd>
<kwd lng="en"><![CDATA[simulation-based training]]></kwd>
<kwd lng="en"><![CDATA[cardiac surgery]]></kwd>
<kwd lng="en"><![CDATA[failure to rescue]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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