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2003, Número 5

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Med Crit 2003; 17 (5)


Vasopresina: una nueva alternativa terapéutica en el enfermo grave

Carrillo ER, Carvajal RR, Hernández AC

Idioma: Español
Referencias bibliográficas: 74
Paginas: 162-171
Archivo PDF: 121.76 Kb.


RESUMEN

En los últimos años se han descrito una serie de alteraciones endocrinológicas asociadas a deterioro hemodinámico y vasodilatación refractaria en el estado de choque y paro cardiaco, una de las cuales por su relevancia es la deficiencia de vasopresina. La vasopresina actúa a través de 3 diferentes receptores de proteína G denominados V1a, V1b y V2. En diversos estudios experimentales y ensayos clínicos se ha demostrado su utilidad en choque séptico, choque post-cardiotomía, choque hipovolémico en fase dilatada, intoxicaciones y en paro cardiaco secundario a taquicardia ventricular sin pulsos y fibrilación ventricular.
En estados de choque con vasodilatación la dosis recomendada es de 0.01 a 0.04 UI/min, dosis más elevadas se asocian a isquemia miocárdica, esplácnica y cutánea. En taquicardia ventricular sin pulsos y fibrilación ventricular de acuerdo a la Asociación Americana de Cardiología es recomendación IIb y se utiliza a dosis única de 40 UI.


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