Carrillo ER, Cedillo THI

Idioma: Español
Referencias bibliográficas: 37
Paginas: 60-70
Archivo PDF: 110.78 Kb.

RESUMEN

La hemorragia es una de las principales complicaciones en el paciente politraumatizado, asociada a una elevada mortalidad. El Colegio Americano de Cirujanos recomienda la reanimación agresiva para este tipo de pacientes, basándose en modelos experimentales de los años cincuenta, que incluyen: restitución del volumen sanguíneo con una relación 3:1 y el mantenimiento de la presión arterial dentro de valores normales hasta el control de la hemorragia. Nuevas evidencias experimentales y clínicas han demostrado que la elevación de la presión arterial dentro de límites normales, previo al control de la hemorragia es deletérea e incrementa la mortalidad. Estas observaciones contribuyeron al desarrollo de los conceptos de hipotensión permisiva, hipotensión deliberada e hipotensión retardada como nuevas alternativas terapéuticas en el manejo del paciente con trauma y hemorragia. El objetivo de este trabajo es revisar los conceptos actuales de hemorragia y su manejo en el paciente con trauma.

REFERENCIAS (EN ESTE ARTÍCULO)

1. Hameed S, Aird W, Cohn M. Oxygen delivery. Crit Care Med 2003;31:S658-667.

2. Dutton RP. Low-pressure resuscitation from hemorrhagic shock. Intern Anesthes Clin 2003;40:19-30.

3. Gutierrez G, Reines H, Gutierrez W. Hemorrhagic shock. Crit Care 2004;8:373-381.

4. Revell M, Greaves I, Porter K. Endpoints for fluid resuscitation in hemorrhagic shock. J Trauma 2003;54:S63-S67.

5. Holmes C, Walley K. Vasopressin in the ICU. Curr Opin Crit Care 2004;10:442-448.

6. McCunn M, Dutton R. End-points of resuscitation: how much is enough? Curr Opin Anaesthesiol 2000;13:147-153.

7. Khan SS, Gray RJ. Valvular emergencies. Cardiol Clin 1991;9:689.

8. Bond RF. Peripheral macro-and microcirculation. In: Schlag G, Redhl H, Eds. Pathophysiology of Shock, sepsis and organ failure. Berlin, Springer-Verlag. 1993.

9. Heaglund U. Systemic mediators released from the gut in critical illness. Crit Care Med 1993;21:S15-8.

10. Stern A, Susan A. Low-volume fluid resuscitation for presumed hemorrhagic shock: helpful or harmful. Curr Opin Crit Care 2001;7:422-430.

11. Baskett PS. ABC of major trauma. Management of hypovolemic shock. BMJ 1990;300:1453-1457.

12. Kreineier. Pathophysiology of fluid imbalance. Critical Care 2000;4:53-57.

13. Arumugam T, Shiels I, Trent M et al. The Role of the complement system in ischemia-reperfusion injury. Shock 2004;21:401-409.

14. Robert I, Phillip E, Bunn F et al. Is the normalization of blood pressure in bleeding trauma patients harmful? Lancet 2001;357:385-87.

15. Jorgensen KA, Stoffersen E. On the inhibitory effect of albumin on platelet aggregation. Thromb Res 1980;17:13-18.

16. Stibbe J, Kirby E. Inhibition of Ristocetin-induced aggregation by Haemaccel. BMJ 1975;2:750-751.

17. Bickell W, Wall M, Pepe P et al. Immediate versus delayed fluid resuscitation for hypotensive patients with penetrating torso injuries. N Engl J Med 1994;331:1105-1109.

18. Dalrymple-Hay M, Aitchison R, Collins P et al. Hydroxyethyl starch induced acquired von Willebrand´s disease. Clin Lab Haematol 1992;14:209-211.

19. Stump D, Strauss R, Henriksenn R et al. Effects of hydroxyethyl starch on blood coagulation, particularly factor VIII. Transfusion 1985;25:349-54.

20. Lucas CE, Ledgerwood A, Mammen E et al. Altered coagulation protein content fther albumin resuscitation. Ann Surg 1982;196:198-202.

21. Mardel SN, Saunders F, Ollerenshaw L et al. Reduced quality of in vitro clot formation with gelatin-based plasma substitutes. Lancet 1996;347:825.

22. Bailén R. Reversible myocardial dysfunction in critically ill, noncardiac patients. Crit Care Med 2002;30:6.

23. William C. Endothelium as an organ system. Crit Care Med 2004;32:s271-79.

24. Varela E, Cohn SM, Díaz I et al. Splanchinc perfusion during delayed, hypotensive, or aggressive fluid resuscitation from uncontrolled hemorrhage. Shock 2003;20:478-480.

25. Carrillo P, Takasu A, Safar P et al. Prolonged severe hemorrhagic shock and resuscitation in rats does not cause subtle brain damage. J Trauma 1998;45:238-249.

26. Greaves KM, Revell. Fluid Resuscitation in Pre-Hospital Trauma Care: a Consensus View. J R Coll Surg Edinb 2002;47:451-457.

27. Hai SA. Permissive hypotension an Evolving Concept in Trauma. J Pakist Trauma Med 2004;45:1-6.

28. Cannon WB, Fraser J, Cowell EM. The preventive treatment of wound shock. JAMA 1918;70:618.

29. Kreimeier SP, Peter K. Permissive hypotension. Scheweiz Med Wochenschr 2000;130:1516-1524.

30. Fowler R, Pepe E. Fluid resuscitation of the patient with major trauma. Curr Opin Anesthes 2002;15:173-178.

31. Committee on Trauma. Advanced Trauma Life Support Program for Physicians. Chicago: American College of Surgeons; 1997:75-110.

32. Martin RR, Bickell WH, Pepe PE, Burch JM et al. Prospective evaluation of preoperatory fluid resuscitation in hypotensive patients with penetrating truncal injury: a preliminary report. J Trauma 1992;33:354-361.

33. Blair SD, Janvrin SB, McCollum CN et al. Effect of early blood transfusion on gastrointestinal haemorrhage. Br J Surg 1996;73:783-785.

34. Dunham CM, Belzberg H, Lyles R et al. The rapid infusion system: a superior method for resuscitation of hypovolemic trauma patients. Resuscitation 1991;21:207-227.

35. Turner J, Nicholl J, Webber L et al. Randomized controlled trial of prehospital intravenous fluid replacement therapy in serious trauma. Health Techno Assess 2000;4:1-57.

36. Rady YM. Bench-to beside review: Resuscitation in the emergency department. Crit Care 2004;810.11186/cc2986.

37. Marcus C, Carr J et al. Monitoring of hemostasis in combat trauma patients military med. 2004;169(Suppl):S11-15.