Rodríguez MCM

Idioma: Español
Referencias bibliográficas: 20
Paginas: 226-229
Archivo PDF: 38.14 Kb.

RESUMEN

El síndrome de respuesta inflamatoria sistémica (SIRS) es un proceso inflamatorio sistémico secundario a una infección confirmada (sepsis), o bien a otros procesos no infecciosos como pancreatitis, isquemia, choque hemorrágico, etc. Depende de la capacidad del organismo para responder a estas agresiones, derivado de la respuesta inmunológica y otros factores que confieren protección.
Existen estudios en ratas y perros donde se encontró una disminución del flujo sanguíneo hepático, desconociéndose aún los mecanismos desencadenantes de alteraciones en la función hepática, pero quizá secundarios a hipoxia e hipoperfusión tisulares.
La presente revisión trata de establecer los posibles mecanismos patogénicos de disfunción hepática en el SIRS, y con ello entender la importancia que tiene en el desarrollo de este síndrome.

REFERENCIAS (EN ESTE ARTÍCULO)

1. Vencenyt JL, Bihari D. Sepsis severe or sepsis syndrome; Need for clarification. Intensive Care Med 1992; 18: 255-257.

2. Bone RC, Sibbald WJ, Sprungh ChL. The ACCP-SCCM. Consensus Conference on Sepsis and Organ Failure. CHEST 1992; 101: 06:1481-82.

3. Members of the American College of Chest Physician Society of Critical Care Medicin Consensus Conference Committee. Definitions for Sepsis and Organ Failure and Guidelines for de use of innovative therapies in sepsis. Critical Care Med 1992; 20(6): 864-73.

4. Bone RC. The pathogenesis of sepsis. Ann Intern Med 1991; 115: 457-69.

5. Anderson GL, Johnson DJ. Splanchnic resuscitation. A Strategy for preventing live failure in sepsis. New horizons 1993; 1(2): 353-59.

6. Kiuchi T, Yamaguchi T, Takada Y et al. Hepatomuscular Failure in septic catabolism: Altered muscular response to plasma proteolytic factors in decreased hepatic mitochondrial redox potential. Surgery 1991; 109(2): 182-9.

7. Ohtake Y and Clemens MG. Interrelationship between hepatic ureagenesis and gluconeogenesis in early sepsis. Am J Physiol 1991; 260(3 Pt 1): E453-58.

8. West MA, Keller GA, Hyland BJ, et al. Hepatocyte function in sepsis: Kuppfer cells mediate a biphasic protein synthesis response in hepatocytes after exposure to endotoxin or Killed Escherichia coli. Surgery 1985; 983: 388-95.

9. Wang PBA, and Ayala A. Hepatocellular dysfunction persists during early sepsis despite increased volume of crystalloid resuscitation. The journal of trauma 1992; 32(3): 389-97.

10. Dahn MS, Lange MP, Wilson RF, et al. Hepatic bool flow and splanchnic oxygen consumption measurements in clinical sepsis. Surgery 1990; 107(3): 295-301.

11. Hasselgren PO, Jagenburg R, Karlstrom L et al. Changes of protein metabolism in liver an skeletal muscle following trauma complicated by sepsis. J Trauma 1984; 24(3): 224-8.

12. Fourrier F, Chopin C, Goundemand J et al. Septic shock, multiple organ failure and disseminated intravascular coagulation. Compared patterns of antithrombin III, Protein C and Protein S deficiencies. CHEST 1992; 101(3): 816-23.

13. Doi F, Goya T and Torisu M. Potential role of hepatic macrophages in neutrophil-mediated liver injury in rats with sepsis. Hepatology 1993; 17(6): 1086-94.

14. Klinik JM, Krakenhaus HS. AT-III in septicaemia with DIC. Intensive Care Med 1993; 19: S16-18.

15. Steffes CHP, Danh MS and Lange MP. Oxygen transport-dependent splachnic metabolism in the sepsis syndrome. Arch Surg 1994; 129(1): 46-52.

16. Harkema JM, Gorman MW, Bieber LL et al. Metabolic interaction between skeletal muscle and liver during bacteremia. Arch Surg 1988; 123(11): 1415-19.

17. Quale JM, Mandel LJ, Bergasa NV et al. Clinical significance and pathogenesis of hiperbillirrubinemia associated with Staphylococcus aureus septicaemia. Am J Med 1988; 85(5): 615-8.

18. Sprung ChL, Peducci PN, Shatney CH et al. Impact of encephalopathy on mortality in the sepsis syndrome. Critical Care Med 1990; 18(08): 801-06.

19. Mizock BA, Sabelli HC, Dubin A et al. Encephalopathy septic. Evidence for altered phenylalanina metabolism and comparison with hepatic encephalopathy. Arch Intern Med 1990; 150(02): 443-9.

20. Rodríguez MM, Valero GJ, Roldán VA. Liver methabolic disorders in the Systemic Inflammatory Response Syndrome (SIRS). Rev Fac Med UNAM 1996; 39(4): 134-8.