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ISSN 2448-8909 (Impreso)

2004, Número 1

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Med Crit 2004; 18 (1)


Rompiendo un paradigma: del modelo humoral al modelo celular de la coagulación. Su aplicación clínica en el enfermo grave

Carrillo ER, Salmerón NP, Carvajal RR, Contreras DV, Hernández AC

Idioma: Español
Referencias bibliográficas: 57
Paginas: 17-23
Archivo PDF: 74.85 Kb.


RESUMEN

El modelo actualmente aceptado de la coagulación se divide en dos vías e incorpora una serie de pasos humorales secuenciales que condicionan la producción de trombina. El modelo celular rompe el paradigma anterior y establece que el complejo factor tisular-factor VII activado (FT-FVIIa) en estrecha interacción con la superficie plaquetaria activa a los diferentes factores de coagulación para la generación de trombina. Se caracteriza por la secuencia iniciación, amplificación, propagación. En base al modelo celular se introdujo en la clínica el empleo del factor VII recombinante activado (rFVIIa). El cual induce hemostasia activando a la plaqueta y a los diferentes factores de la coagulación en la superficie de ésta. Inicialmente su indicación era para enfermos hemofílicos con inhibidores. En la actualidad su empleo se ha extendido a niños y adultos críticamente enfermos con hemorragia microvascular y sangrado incoercible como el que se presenta en trauma, trasplante de hígado, cirugía cardiopulmonar, insuficiencia renal y hepática, neurocirugía, intoxicación por anticoagulantes orales y disfunción plaquetaria.


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