Luna OP, Serrano VX, Fernández RB, Rojas PE

Idioma: Español
Referencias bibliográficas: 103
Paginas: 87-100
Archivo PDF: 278.83 Kb.

RESUMEN

El calcio (Ca++) juega un papel muy importante en el mantenimiento y regulación de la función cardiaca normal. La fuerza de contracción miocárdica se altera por cambios en la entrada de calcio a la célula, los niveles de calcio en los sitios de almacenamiento y sensibilidad de calcio por las proteínas contráctiles. La homeostasis del ion calcio es esencial para muchos procesos biológicos, los que incluyen: el automatismo cardiaco, el acoplamiento excitación-contracción en el miocardio y en el músculo liso y esquelético, sobre la coagulación de la sangre, la conducción neuronal, la transmisión sináptica, la secreción de hormonas y la división mitótica celular. El calcio es también un importante mensajero intracelular necesario para la función celular normal y es requerido por muchas enzimas para su actividad total, y para el mantenimiento del tono vascular. El calcio juega un papel central en un gran número de acciones fisiológicas que son esenciales para la vida. Por lo tanto es muy importante que el anestesiólogo conozca la fisiopatología del calcio. En esta revisión se discutirá, la fisiología, regulación, características clínicas, causas y tratamiento de los cambios en el calcio circulante. Además el efecto del calcio sobre muchos fármacos usados durante la anestesia como los anestésicos locales, intravenosos e inhalados, los relajantes musculares, el estado acidobase, la transfusión masiva de sangre y la circulación extracorpórea. Finalmente la participación del calcio en la lesión por isquemia/reperfusión y el corazón aturdido. El anestesiólogo debe estar preparado para prevenir los cambios en la concentración del calcio en plasma y para reconocer y tratar los efectos adversos de la hipo e hipercalcemia, particularmente los efectos sobre el corazón.

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